Provider Demographics
NPI:1740002351
Name:DUMAS, SABRINA NICOLA
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:NICOLA
Last Name:DUMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 SAYBROOK RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-2522
Mailing Address - Country:US
Mailing Address - Phone:520-285-7515
Mailing Address - Fax:
Practice Address - Street 1:1026 SAYBROOK RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-2522
Practice Address - Country:US
Practice Address - Phone:520-285-7515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-26
Last Update Date:2024-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5888-29133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered