Provider Demographics
NPI:1699545723
Name:KATE'S DALEY EATS NUTRITION
Entity type:Organization
Organization Name:KATE'S DALEY EATS NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:MISS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DALEY
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:860-876-0637
Mailing Address - Street 1:54 JAMES VINCENT DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:CT
Mailing Address - Zip Code:06413-1259
Mailing Address - Country:US
Mailing Address - Phone:860-876-0637
Mailing Address - Fax:
Practice Address - Street 1:54 JAMES VINCENT DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:CT
Practice Address - Zip Code:06413-1259
Practice Address - Country:US
Practice Address - Phone:860-876-0637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service