Provider Demographics
NPI:1144611476
Name:LOTHEN-KLINE, CHRISTINE (RDN, LDN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:LOTHEN-KLINE
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6137 GATE SILL
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-4016
Mailing Address - Country:US
Mailing Address - Phone:443-794-7187
Mailing Address - Fax:
Practice Address - Street 1:10280 OLD COLUMBIA RD
Practice Address - Street 2:SUITE 220
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1796
Practice Address - Country:US
Practice Address - Phone:443-794-7187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD01566133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD01566OtherDIETETIC LICENSURE