Provider Demographics
NPI:1093113516
Name:COSH, HAYLEY LORRAINE (RD)
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:LORRAINE
Last Name:COSH
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:HAYLEY
Other - Middle Name:
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:618 MAIN ST UNIT 3304
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:RI
Mailing Address - Zip Code:02816-7892
Mailing Address - Country:US
Mailing Address - Phone:760-845-6062
Mailing Address - Fax:401-793-0094
Practice Address - Street 1:164 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-2853
Practice Address - Country:US
Practice Address - Phone:401-793-4719
Practice Address - Fax:401-793-0094
Is Sole Proprietor?:No
Enumeration Date:2014-12-16
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILDN00812133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered