Provider Demographics
NPI:1588182034
Name:MCLAUGHLIN, CAMILLE (RDN, LD)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 669
Mailing Address - Street 2:
Mailing Address - City:ANTRIM
Mailing Address - State:NH
Mailing Address - Zip Code:03440-0669
Mailing Address - Country:US
Mailing Address - Phone:603-714-2164
Mailing Address - Fax:
Practice Address - Street 1:42 MAIN ST
Practice Address - Street 2:
Practice Address - City:ANTRIM
Practice Address - State:NH
Practice Address - Zip Code:03440-3906
Practice Address - Country:US
Practice Address - Phone:603-714-2164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-05
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0914133NN1002X, 133VN1004X, 133N00000X, 133VN1005X, 133VN1006X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic