Provider Demographics
NPI:1356668099
Name:COLLINGTON, RAELEENA (EDD, MBA, MS, LN)
Entity Type:Individual
Prefix:DR
First Name:RAELEENA
Middle Name:
Last Name:COLLINGTON
Suffix:
Gender:F
Credentials:EDD, MBA, MS, LN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9065 N LAUREL RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-1569
Mailing Address - Country:US
Mailing Address - Phone:202-929-8102
Mailing Address - Fax:
Practice Address - Street 1:9065 N LAUREL RD UNIT J
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-1569
Practice Address - Country:US
Practice Address - Phone:202-929-8102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-20
Last Update Date:2022-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNU100000172133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist