Provider Demographics
NPI:1376718585
Name:PLATKA-BIRD, LORRAINE (PHD, RD)
Entity Type:Individual
Prefix:DR
First Name:LORRAINE
Middle Name:
Last Name:PLATKA-BIRD
Suffix:
Gender:F
Credentials:PHD, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:748 S MEADOWS PKWY
Mailing Address - Street 2:# A9-128
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-3861
Mailing Address - Country:US
Mailing Address - Phone:775-292-0467
Mailing Address - Fax:
Practice Address - Street 1:1291 BOLIVIA WAY
Practice Address - Street 2:
Practice Address - City:GARDNERVILLE
Practice Address - State:NV
Practice Address - Zip Code:89460-8604
Practice Address - Country:US
Practice Address - Phone:775-265-0965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
R621367101Y00000X
NVR621367133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No101Y00000XBehavioral Health & Social Service ProvidersCounselor