Healthcare Provider Details

I. General information

NPI: 1053667915
Provider Name (Legal Business Name): DOLINDA WERLING-BAYE R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2012
Last Update Date: 07/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PARK RIDGE DR
RIVER RIDGE LA
70123-1175
US

IV. Provider business mailing address

400 PARK RIDGE DR
RIVER RIDGE LA
70123-1175
US

V. Phone/Fax

Practice location:
  • Phone: 504-452-5421
  • Fax:
Mailing address:
  • Phone: 504-452-5421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number613
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: