Provider Demographics
NPI:1184020455
Name:LAMSON, HEATHER (RD, LDN)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:LAMSON
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3465 OLD BETHLEHEM PIKE
Mailing Address - Street 2:
Mailing Address - City:COOPERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18036-2807
Mailing Address - Country:US
Mailing Address - Phone:484-433-2022
Mailing Address - Fax:
Practice Address - Street 1:3465 OLD BETHLEHEM PIKE
Practice Address - Street 2:
Practice Address - City:COOPERSBURG
Practice Address - State:PA
Practice Address - Zip Code:18036-2807
Practice Address - Country:US
Practice Address - Phone:484-433-2022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-13
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN005408133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered