Provider Demographics
NPI:1942874912
Name:DOTSON, JACQUALINE JEAN (RDLDN)
Entity Type:Individual
Prefix:
First Name:JACQUALINE
Middle Name:JEAN
Last Name:DOTSON
Suffix:
Gender:F
Credentials:RDLDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 CARPHILLY CIR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069-4358
Mailing Address - Country:US
Mailing Address - Phone:931-802-3170
Mailing Address - Fax:
Practice Address - Street 1:150 CARPHILLY CIR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37069-4358
Practice Address - Country:US
Practice Address - Phone:931-802-3170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-14
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management