Provider Demographics
NPI:1265051452
Name:ZOLD, DANIELLE (RD, CLC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:ZOLD
Suffix:
Gender:F
Credentials:RD, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 E ALAMEDA AVE APT 13-103
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1187
Mailing Address - Country:US
Mailing Address - Phone:262-501-4377
Mailing Address - Fax:
Practice Address - Street 1:8600 E ALAMEDA AVE APT 13-103
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-1187
Practice Address - Country:US
Practice Address - Phone:262-501-4377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO86092867133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty