Provider Demographics
NPI:1093442675
Name:CUMBERLAND, ALEXIS JONES (LDN)
Entity Type:Individual
Prefix:MRS
First Name:ALEXIS
Middle Name:JONES
Last Name:CUMBERLAND
Suffix:
Gender:F
Credentials:LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 MARGUERITE ST
Mailing Address - Street 2:
Mailing Address - City:MORGAN CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70380-1855
Mailing Address - Country:US
Mailing Address - Phone:985-380-4332
Mailing Address - Fax:985-202-2622
Practice Address - Street 1:1125 MARGUERITE ST
Practice Address - Street 2:
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-1855
Practice Address - Country:US
Practice Address - Phone:985-380-4332
Practice Address - Fax:985-202-2622
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3414133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education