Provider Demographics
NPI:1497052195
Name:SEGELMAN, LAURA (NC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:SEGELMAN
Suffix:
Gender:F
Credentials:NC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2577 VALERIE CT
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-1961
Mailing Address - Country:US
Mailing Address - Phone:831-421-2121
Mailing Address - Fax:831-477-7878
Practice Address - Street 1:2577 VALERIE CT
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-1961
Practice Address - Country:US
Practice Address - Phone:831-421-2121
Practice Address - Fax:831-477-7878
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist