Provider Demographics
NPI:1366816001
Name:DONATTO, SHELETTA (RD)
Entity Type:Individual
Prefix:
First Name:SHELETTA
Middle Name:
Last Name:DONATTO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10343 SIEGEN LN STE 3A
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-4981
Mailing Address - Country:US
Mailing Address - Phone:225-767-4440
Mailing Address - Fax:225-767-4441
Practice Address - Street 1:10343 SIEGEN LN STE 3A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-4981
Practice Address - Country:US
Practice Address - Phone:225-767-4440
Practice Address - Fax:225-767-4441
Is Sole Proprietor?:No
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA800141133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA800141OtherCOMMISSION ON DIETETIC REGISTRATION