Provider Demographics
NPI:1093014482
Name:SEGRETI, LENNA FRANCES (RD)
Entity Type:Individual
Prefix:MS
First Name:LENNA
Middle Name:FRANCES
Last Name:SEGRETI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2810 SELWYN AVE
Mailing Address - Street 2:UNIT 214
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-1775
Mailing Address - Country:US
Mailing Address - Phone:919-417-0239
Mailing Address - Fax:
Practice Address - Street 1:2810 SELWYN AVE
Practice Address - Street 2:UNIT 214
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-1775
Practice Address - Country:US
Practice Address - Phone:919-417-0239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003095133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered