Provider Demographics
NPI:1689039034
Name:TOMASKO, LAUREN (RDN, CDCES)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:TOMASKO
Suffix:
Gender:F
Credentials:RDN, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2251 N SQUIRREL RD STE 330
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-4610
Mailing Address - Country:US
Mailing Address - Phone:248-601-7593
Mailing Address - Fax:
Practice Address - Street 1:2251 N SQUIRREL RD STE 330
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-4610
Practice Address - Country:US
Practice Address - Phone:248-601-7593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-29
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI966160133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered