Provider Demographics
NPI:1225785348
Name:DECHAMBEAU, LAUREN (RDN, CDN, CLC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:DECHAMBEAU
Suffix:
Gender:F
Credentials:RDN, CDN, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5074 UPPER MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-9634
Mailing Address - Country:US
Mailing Address - Phone:716-957-2106
Mailing Address - Fax:
Practice Address - Street 1:5074 UPPER MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-9634
Practice Address - Country:US
Practice Address - Phone:716-957-2106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No174N00000XOther Service ProvidersLactation Consultant, Non-RN