Healthcare Provider Details

I. General information

NPI: 1649573114
Provider Name (Legal Business Name): CAITLIN MARIE CLOUTIER R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2010
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2332 CENTRAL PARK BLVD
DENVER CO
80238-3234
US

IV. Provider business mailing address

2332 CENTRAL PARK BLVD
DENVER CO
80238-3234
US

V. Phone/Fax

Practice location:
  • Phone: 317-506-5439
  • Fax:
Mailing address:
  • Phone: 317-506-5439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1037370
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: