Provider Demographics
NPI:1093854416
Name:DOMPIER, KIMBERLEY JOY (MS, RD, CD-N)
Entity type:Individual
Prefix:MS
First Name:KIMBERLEY
Middle Name:JOY
Last Name:DOMPIER
Suffix:
Gender:F
Credentials:MS, RD, CD-N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 BUTTER JONES ROAD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06412
Mailing Address - Country:US
Mailing Address - Phone:860-526-1431
Mailing Address - Fax:
Practice Address - Street 1:41 BREWSTER ROAD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06011-0977
Practice Address - Country:US
Practice Address - Phone:860-585-3166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000137133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered