Provider Demographics
NPI:1114261955
Name:TROCCHIO, LAUREN (RD, LD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:TROCCHIO
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 S SHIRLINGTON RD
Mailing Address - Street 2:505
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-3601
Mailing Address - Country:US
Mailing Address - Phone:571-356-5164
Mailing Address - Fax:888-972-8103
Practice Address - Street 1:2800 S SHIRLINGTON RD
Practice Address - Street 2:505
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-3601
Practice Address - Country:US
Practice Address - Phone:571-356-5164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-17
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDI100000479133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered