Provider Demographics
NPI:1114077898
Name:LATHROP, ARLENE V (RD)
Entity Type:Individual
Prefix:MRS
First Name:ARLENE
Middle Name:V
Last Name:LATHROP
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:PO BOX 35805
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71294-5805
Mailing Address - Country:US
Mailing Address - Phone:318-329-4395
Mailing Address - Fax:318-329-4393
Practice Address - Street 1:102 THOMAS RD
Practice Address - Street 2:SUITE 106
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-7366
Practice Address - Country:US
Practice Address - Phone:318-329-4395
Practice Address - Fax:318-329-4393
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA452133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4C392Medicare ID - Type UnspecifiedLAMCARE IND PROV ID