Provider Demographics
NPI:1477670289
Name:POWER, LAURA W (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:W
Last Name:POWER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6521 ARLINGTON BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-3016
Mailing Address - Country:US
Mailing Address - Phone:703-538-4161
Mailing Address - Fax:703-538-4239
Practice Address - Street 1:6521 ARLINGTON BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3016
Practice Address - Country:US
Practice Address - Phone:703-538-4161
Practice Address - Fax:703-538-4239
Is Sole Proprietor?:No
Enumeration Date:2007-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDNOO198133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist