Provider Demographics
NPI:1134487465
Name:COURTNEY, DENISE LEE (MS, RD, LDN)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:LEE
Last Name:COURTNEY
Suffix:
Gender:F
Credentials:MS, 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:PO BOX 95013
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02495-0013
Mailing Address - Country:US
Mailing Address - Phone:413-222-6119
Mailing Address - Fax:
Practice Address - Street 1:128 LINWOOD AVE
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02460-1427
Practice Address - Country:US
Practice Address - Phone:413-222-6119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3229133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered