Provider Demographics
NPI:1235472945
Name:RACHAL, CYNTHIA H (RDN, LDN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:H
Last Name:RACHAL
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 1:1450 POYDRAS ST
Mailing Address - Street 2:1938
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-1227
Mailing Address - Country:US
Mailing Address - Phone:504-568-8190
Mailing Address - Fax:
Practice Address - Street 1:1525 FAIRFIELD AVE
Practice Address - Street 2:RM 569
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4300
Practice Address - Country:US
Practice Address - Phone:318-676-7489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-01
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1054133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered