Provider Demographics
NPI:1023835030
Name:HART, DEBORAH R (RDN)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:R
Last Name:HART
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6375 DEXTER ANN ARBOR RD
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:MI
Mailing Address - Zip Code:48130-8529
Mailing Address - Country:US
Mailing Address - Phone:734-368-5297
Mailing Address - Fax:
Practice Address - Street 1:6375 DEXTER ANN ARBOR RD
Practice Address - Street 2:
Practice Address - City:DEXTER
Practice Address - State:MI
Practice Address - Zip Code:48130-8529
Practice Address - Country:US
Practice Address - Phone:734-368-5297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-21
Last Update Date:2024-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered