Provider Demographics
NPI:1063086916
Name:DONLEY, MIA (RD)
Entity type:Individual
Prefix:
First Name:MIA
Middle Name:
Last Name:DONLEY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4715 MEADE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-1165
Mailing Address - Country:US
Mailing Address - Phone:334-791-3350
Mailing Address - Fax:
Practice Address - Street 1:5335 W 48TH AVE STE 500
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80212-2732
Practice Address - Country:US
Practice Address - Phone:334-791-3350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-15
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered