Healthcare Provider Details

I. General information

NPI: 1265051452
Provider Name (Legal Business Name): DANIELLE ZOLD RD, CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2020
Last Update Date: 04/08/2020
Certification Date: 04/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 E ALAMEDA AVE APT 13-103
DENVER CO
80247-1187
US

IV. Provider business mailing address

8600 E ALAMEDA AVE APT 13-103
DENVER CO
80247-1187
US

V. Phone/Fax

Practice location:
  • Phone: 262-501-4377
  • Fax:
Mailing address:
  • Phone: 262-501-4377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86092867
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: