Provider Demographics
NPI:1760947162
Name:KINSEY, DALIA (REGISTERED DIETITIAN)
Entity Type:Individual
Prefix:
First Name:DALIA
Middle Name:
Last Name:KINSEY
Suffix:
Gender:F
Credentials:REGISTERED DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 SWEET GUM DR
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30223-7291
Mailing Address - Country:US
Mailing Address - Phone:470-488-9296
Mailing Address - Fax:
Practice Address - Street 1:316 SWEET GUM DR
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30223-7291
Practice Address - Country:US
Practice Address - Phone:470-488-9296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-10
Last Update Date:2019-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD004804133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered