Provider Demographics
NPI:1679124713
Name:MORING, CATHERINE (RD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:MORING
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 SOUTH MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:MS
Mailing Address - Zip Code:38921
Mailing Address - Country:US
Mailing Address - Phone:662-625-7110
Mailing Address - Fax:
Practice Address - Street 1:401 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:MS
Practice Address - Zip Code:38921-2257
Practice Address - Country:US
Practice Address - Phone:662-625-7110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-20
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSDL2022133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered