Provider Demographics
NPI:1497714349
Name:CAPLIS, KASEY JO (RD, LD)
Entity Type:Individual
Prefix:
First Name:KASEY
Middle Name:JO
Last Name:CAPLIS
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 SOUTH RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-2308
Mailing Address - Country:US
Mailing Address - Phone:405-623-7467
Mailing Address - Fax:
Practice Address - Street 1:130 MARSHALL RD
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-5130
Practice Address - Country:US
Practice Address - Phone:978-671-9118
Practice Address - Fax:978-671-9149
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1336133V00000X
MA2623133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered