Provider Demographics
NPI:1487201596
Name:LOUIE, SAMANTHA (RDN)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:LOUIE
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14320 POTOMAC HEIGHTS LN
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3844
Mailing Address - Country:US
Mailing Address - Phone:415-810-2189
Mailing Address - Fax:
Practice Address - Street 1:14320 POTOMAC HEIGHTS LN
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3844
Practice Address - Country:US
Practice Address - Phone:415-810-2189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education