Provider Demographics
NPI:1295815264
Name:WATSON, LAURA LEE (RD, LD, CDE, MPH)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:LEE
Last Name:WATSON
Suffix:
Gender:F
Credentials:RD, LD, CDE, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 GRAYCROFT DR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-1753
Mailing Address - Country:US
Mailing Address - Phone:256-603-1232
Mailing Address - Fax:
Practice Address - Street 1:620 GRAYCROFT DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-1753
Practice Address - Country:US
Practice Address - Phone:256-603-1232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2021-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1690133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered