Provider Demographics
NPI:1306438106
Name:OLOFSSON, CARA (RDN)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:OLOFSSON
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 W DRAKE RD STE 232
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-2880
Mailing Address - Country:US
Mailing Address - Phone:708-717-7394
Mailing Address - Fax:720-306-3508
Practice Address - Street 1:343 W DRAKE RD STE 232
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-2880
Practice Address - Country:US
Practice Address - Phone:708-717-7394
Practice Address - Fax:720-306-3508
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1066529133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered