Provider Demographics
NPI:1194009928
Name:HATCH, LAURIE MARLENE (RD)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:MARLENE
Last Name:HATCH
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 1:667 S 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-3459
Mailing Address - Country:US
Mailing Address - Phone:860-280-6297
Mailing Address - Fax:720-247-9239
Practice Address - Street 1:667 S 22ND AVE
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-3459
Practice Address - Country:US
Practice Address - Phone:860-280-6297
Practice Address - Fax:720-247-9239
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-28
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered