Provider Demographics
NPI:1821491382
Name:DUNN, MALIA BRIANNA (RDN)
Entity Type:Individual
Prefix:MRS
First Name:MALIA
Middle Name:BRIANNA
Last Name:DUNN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:MS
Other - First Name:MALIA
Other - Middle Name:BRIANNA
Other - Last Name:CABLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:2935 BASELINE RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-2366
Mailing Address - Country:US
Mailing Address - Phone:970-818-2174
Mailing Address - Fax:
Practice Address - Street 1:2935 BASELINE RD
Practice Address - Street 2:SUITE 302
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-2366
Practice Address - Country:US
Practice Address - Phone:970-818-2174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-29
Last Update Date:2016-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO86002441133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered