Provider Demographics
NPI:1073791851
Name:DIABETES MANAGEMENT CONSULTANTS LLC
Entity Type:Organization
Organization Name:DIABETES MANAGEMENT CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:LAMAR
Authorized Official - Suffix:
Authorized Official - Credentials:RD CDE
Authorized Official - Phone:702-267-7752
Mailing Address - Street 1:9976 WILDE WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-5537
Mailing Address - Country:US
Mailing Address - Phone:702-267-7752
Mailing Address - Fax:
Practice Address - Street 1:9976 WILDE WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5537
Practice Address - Country:US
Practice Address - Phone:702-267-7752
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM824138133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty