Provider Demographics
NPI:1548301146
Name:SIGMOND, DONNA (RD, LAC, DIPL OM)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:SIGMOND
Suffix:
Gender:F
Credentials:RD, LAC, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1148 WEST DILLON ROAD, STE. 1
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027
Mailing Address - Country:US
Mailing Address - Phone:030-355-4160
Mailing Address - Fax:
Practice Address - Street 1:1148 WEST DILLON ROAD, STE. 1
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:CO
Practice Address - Zip Code:80027
Practice Address - Country:US
Practice Address - Phone:030-355-4160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO863728133V00000X
CO1062171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered