Provider Demographics
NPI:1598274136
Name:HAMILTON, LAURA (RDN, CSP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:RDN, CSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3744 CHATTAHOOCHEE SUMMIT DR SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3245
Mailing Address - Country:US
Mailing Address - Phone:315-382-8990
Mailing Address - Fax:
Practice Address - Street 1:3744 CHATTAHOOCHEE SUMMIT DR SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-3245
Practice Address - Country:US
Practice Address - Phone:315-382-8990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered