Provider Demographics
NPI:1114259736
Name:DAUBERT, HAYLEY E (RD, LDN)
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:E
Last Name:DAUBERT
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2041 FIELDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-8407
Mailing Address - Country:US
Mailing Address - Phone:610-360-0486
Mailing Address - Fax:610-365-8587
Practice Address - Street 1:6083 HAMILTON BLVD
Practice Address - Street 2:
Practice Address - City:WESCOSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18106-9767
Practice Address - Country:US
Practice Address - Phone:610-360-0486
Practice Address - Fax:610-365-8587
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-06
Last Update Date:2010-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN001397133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered