Provider Demographics
NPI:1396236972
Name:SINNOTT, COLLETTE ASHLEY (RD, LD, CPT)
Entity type:Individual
Prefix:
First Name:COLLETTE
Middle Name:ASHLEY
Last Name:SINNOTT
Suffix:
Gender:F
Credentials:RD, LD, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 CARMEN BLVD UNIT 1004
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-1780
Mailing Address - Country:US
Mailing Address - Phone:503-523-7769
Mailing Address - Fax:
Practice Address - Street 1:6100 CARMEN BLVD UNIT 1004
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-1780
Practice Address - Country:US
Practice Address - Phone:503-523-7769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-19
Last Update Date:2018-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV39241-DI-0133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty