Healthcare Provider Details

I. General information

NPI: 1982153979
Provider Name (Legal Business Name): RICCI-LEE HOTZ MS, RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 S YUKON ST STE 320
LAKEWOOD CO
80226-4333
US

IV. Provider business mailing address

12081 W ALAMEDA PKWY STE 425
LAKEWOOD CO
80228-2701
US

V. Phone/Fax

Practice location:
  • Phone: 520-230-2636
  • Fax: 520-844-1110
Mailing address:
  • Phone: 520-230-2636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86054333
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: