Provider Demographics
NPI:1518585892
Name:DAHLIN, DANIELLE (RD)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:DAHLIN
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 1:2700 S ROAN ST
Mailing Address - Street 2:STE 212
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-7557
Mailing Address - Country:US
Mailing Address - Phone:423-335-5309
Mailing Address - Fax:
Practice Address - Street 1:2700 S ROAN ST STE 212
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-7557
Practice Address - Country:US
Practice Address - Phone:423-530-6556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-13
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3843133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered