Doctor Name: | NICOLE THERIAULT DOUGHTY |
NPI Number: | 1962593665 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD, LD |
License Number: | D1710 |
Business Practice Address: | 140 Academy St Presque Isle, ME - 047693102 |
Business Phone Number: | 2077684358 |
Business Fax Number: | |
Mailing Address: | 41 Roosevelt Ave, Po Box 948 FORT FAIRFIELD |
State: | ME |
Postal Code: | 047421126 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/27/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | D1710 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |