Provider Demographics
NPI:1598322216
Name:NUTRITION COUNSELING VALERIE LAWRENCE
Entity Type:Organization
Organization Name:NUTRITION COUNSELING VALERIE LAWRENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RD
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-365-8212
Mailing Address - Street 1:2111 JUBILEE LN
Mailing Address - Street 2:
Mailing Address - City:EMMETT
Mailing Address - State:ID
Mailing Address - Zip Code:83617-4500
Mailing Address - Country:US
Mailing Address - Phone:208-365-8212
Mailing Address - Fax:208-550-3225
Practice Address - Street 1:709 S WASHINGTON AVE APT B
Practice Address - Street 2:
Practice Address - City:EMMETT
Practice Address - State:ID
Practice Address - Zip Code:83617-3597
Practice Address - Country:US
Practice Address - Phone:208-365-8212
Practice Address - Fax:208-550-3225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-29
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty