Provider Demographics
NPI:1386768984
Name:DEPINTO, SHELLEY L (MS, RD, LDN)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:L
Last Name:DEPINTO
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:SHELLEY
Other - Middle Name:L
Other - Last Name:BOHANAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:304 TINSMAN DR
Mailing Address - Street 2:
Mailing Address - City:PERKASIE
Mailing Address - State:PA
Mailing Address - Zip Code:18944-4422
Mailing Address - Country:US
Mailing Address - Phone:215-766-8341
Mailing Address - Fax:
Practice Address - Street 1:123 N MAIN ST
Practice Address - Street 2:ROOM 102C2
Practice Address - City:DUBLIN
Practice Address - State:PA
Practice Address - Zip Code:18917-2107
Practice Address - Country:US
Practice Address - Phone:610-533-8860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003403133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered