Provider Demographics
NPI:1023117595
Name:DALTON, CECILIA COOK (RD,LD)
Entity type:Individual
Prefix:MRS
First Name:CECILIA
Middle Name:COOK
Last Name:DALTON
Suffix:
Gender:F
Credentials:RD,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 ARROWHEAD DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-4105
Mailing Address - Country:US
Mailing Address - Phone:334-202-4342
Mailing Address - Fax:334-277-8929
Practice Address - Street 1:CENTRAL ALABAMA KIDNEY AND HYPERTENSION CENTER
Practice Address - Street 2:4163 LOMAC STREET
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106
Practice Address - Country:US
Practice Address - Phone:334-396-5570
Practice Address - Fax:334-396-5572
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL270133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal