Provider Demographics
NPI:1487622866
Name:SENECAL, NICOLE M (LDN, RD)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:M
Last Name:SENECAL
Suffix:
Gender:F
Credentials:LDN, RD
Other - Prefix:MRS
Other - First Name:NICOLE
Other - Middle Name:M
Other - Last Name:ALTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LDN, RD
Mailing Address - Street 1:4500 S LANCASTER RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75216-7167
Mailing Address - Country:US
Mailing Address - Phone:214-857-0094
Mailing Address - Fax:
Practice Address - Street 1:4500 S LANCASTER RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-7167
Practice Address - Country:US
Practice Address - Phone:214-857-0094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA354133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered