Provider Demographics
NPI:1689927436
Name:RICHARDS, DIONNE ALECIA ANN (RD)
Entity Type:Individual
Prefix:MS
First Name:DIONNE
Middle Name:ALECIA ANN
Last Name:RICHARDS
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 1:1353 E 56TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-3331
Mailing Address - Country:US
Mailing Address - Phone:347-409-6672
Mailing Address - Fax:
Practice Address - Street 1:1311 W MARLETTE ST
Practice Address - Street 2:SPACE 44
Practice Address - City:IONE
Practice Address - State:CA
Practice Address - Zip Code:95640-9782
Practice Address - Country:US
Practice Address - Phone:347-409-6672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-17
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered