Provider Demographics
NPI:1437973872
Name:HOLLINGSWORTH, SYDNEY (RD)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:HOLLINGSWORTH
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E MINT LN
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-7543
Mailing Address - Country:US
Mailing Address - Phone:602-525-8144
Mailing Address - Fax:
Practice Address - Street 1:205 E MINT LN
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140-7543
Practice Address - Country:US
Practice Address - Phone:602-525-8144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT91317133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered