Provider Demographics
NPI:1922898576
Name:DORSEY, CHARLOTTE (RD, CLC)
Entity type:Individual
Prefix:MRS
First Name:CHARLOTTE
Middle Name:
Last Name:DORSEY
Suffix:
Gender:F
Credentials:RD, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5296 SAINT PAULS RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21102-2424
Mailing Address - Country:US
Mailing Address - Phone:443-912-2293
Mailing Address - Fax:
Practice Address - Street 1:532 BALTIMORE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6118
Practice Address - Country:US
Practice Address - Phone:667-367-2778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX6853133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered