Provider Demographics
NPI:1841676319
Name:DOOLING, NICHOLE PATRICIA (RDN)
Entity type:Individual
Prefix:
First Name:NICHOLE
Middle Name:PATRICIA
Last Name:DOOLING
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 1:10 PINEHOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:BALLSTON SPA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-2723
Mailing Address - Country:US
Mailing Address - Phone:518-937-8748
Mailing Address - Fax:
Practice Address - Street 1:10 PINEHOLLOW DR
Practice Address - Street 2:
Practice Address - City:BALLSTON SPA
Practice Address - State:NY
Practice Address - Zip Code:12020-2723
Practice Address - Country:US
Practice Address - Phone:518-937-8748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-06
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1095769133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered