Provider Demographics
NPI:1427177344
Name:PAOLICELLI, COURTNEY PAIGE (DRPH, RD, LD, CDCES)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:PAIGE
Last Name:PAOLICELLI
Suffix:
Gender:F
Credentials:DRPH, RD, LD, CDCES
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:WINSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPH, RD
Mailing Address - Street 1:387 CAMERON STATION BLVD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-8680
Mailing Address - Country:US
Mailing Address - Phone:619-325-9414
Mailing Address - Fax:
Practice Address - Street 1:387 CAMERON STATION BLVD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-8680
Practice Address - Country:US
Practice Address - Phone:619-325-9414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA946850133V00000X
DCDI200001939133V00000X
TXDT82444133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered