Provider Demographics
NPI:1114566593
Name:DALTON, CAITLIN (RD, IBCLC)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:DALTON
Suffix:
Gender:F
Credentials:RD, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 N CULVERTON RD
Mailing Address - Street 2:
Mailing Address - City:WINNABOW
Mailing Address - State:NC
Mailing Address - Zip Code:28479-2103
Mailing Address - Country:US
Mailing Address - Phone:910-599-2573
Mailing Address - Fax:
Practice Address - Street 1:424 N CULVERTON RD
Practice Address - Street 2:
Practice Address - City:WINNABOW
Practice Address - State:NC
Practice Address - Zip Code:28479-2103
Practice Address - Country:US
Practice Address - Phone:910-599-2573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered