Provider Demographics
NPI:1669135711
Name:CAULEY, MARY ALEXANDRIA (MS, RDN)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ALEXANDRIA
Last Name:CAULEY
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 CHANCELLOR PL
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-4545
Mailing Address - Country:US
Mailing Address - Phone:252-373-9536
Mailing Address - Fax:
Practice Address - Street 1:2013 CHANCELLOR PL
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-4545
Practice Address - Country:US
Practice Address - Phone:252-373-9536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty