Provider Demographics
NPI:1326366261
Name:LAWSON, DINA (RD, CDN)
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:
Last Name:LAWSON
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3681 STATE ROUTE 8
Mailing Address - Street 2:
Mailing Address - City:COLD BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:13324-4206
Mailing Address - Country:US
Mailing Address - Phone:315-826-5360
Mailing Address - Fax:315-826-5360
Practice Address - Street 1:3681 STATE ROUTE 8
Practice Address - Street 2:
Practice Address - City:COLD BROOK
Practice Address - State:NY
Practice Address - Zip Code:13324-4206
Practice Address - Country:US
Practice Address - Phone:315-826-5360
Practice Address - Fax:315-826-5360
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-16
Last Update Date:2010-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006924-1133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist