Provider Demographics
NPI:1265679070
Name:MORALES, VICKY MARIE (RD, LDN, CDE)
Entity Type:Individual
Prefix:MISS
First Name:VICKY
Middle Name:MARIE
Last Name:MORALES
Suffix:
Gender:F
Credentials:RD, LDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 DELACROIX HWY
Mailing Address - Street 2:
Mailing Address - City:SAINT BERNARD
Mailing Address - State:LA
Mailing Address - Zip Code:70085-4669
Mailing Address - Country:US
Mailing Address - Phone:504-281-2800
Mailing Address - Fax:504-278-4692
Practice Address - Street 1:4901 DELACROIX HWY
Practice Address - Street 2:
Practice Address - City:SAINT BERNARD
Practice Address - State:LA
Practice Address - Zip Code:70085-4669
Practice Address - Country:US
Practice Address - Phone:504-281-2800
Practice Address - Fax:504-278-4692
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA896323133V00000X
LA1757174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174H00000XOther Service ProvidersHealth Educator