Provider Demographics
NPI:1194014217
Name:DANZ, CAITLIN MARIE (RD, LDN, CLT)
Entity Type:Individual
Prefix:MISS
First Name:CAITLIN
Middle Name:MARIE
Last Name:DANZ
Suffix:
Gender:F
Credentials:RD, LDN, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-3728
Mailing Address - Country:US
Mailing Address - Phone:508-654-8707
Mailing Address - Fax:781-459-1053
Practice Address - Street 1:2 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131
Practice Address - Country:US
Practice Address - Phone:508-654-8707
Practice Address - Fax:781-459-1053
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3125133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered