Provider Demographics
NPI:1851816250
Name:HARRISON, HALI (MS, RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:HALI
Middle Name:
Last Name:HARRISON
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2602 THOREAU DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-1487
Mailing Address - Country:US
Mailing Address - Phone:479-629-2525
Mailing Address - Fax:
Practice Address - Street 1:800 E 20TH ST STE 350
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3884
Practice Address - Country:US
Practice Address - Phone:307-633-7292
Practice Address - Fax:307-633-7998
Is Sole Proprietor?:No
Enumeration Date:2017-08-07
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY218133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered