Provider Demographics
NPI:1235901943
Name:LATOUR, KATHERINE ALESA (MPH, RDN)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ALESA
Last Name:LATOUR
Suffix:
Gender:F
Credentials:MPH, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10901 E MCDOWELL RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85256-5300
Mailing Address - Country:US
Mailing Address - Phone:480-362-3355
Mailing Address - Fax:
Practice Address - Street 1:10901 E MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85256-5300
Practice Address - Country:US
Practice Address - Phone:480-362-3355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86077334133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered