Provider Demographics
NPI:1851662159
Name:STANTON, KATHERINE ANNE (MS, RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:ANNE
Last Name:STANTON
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70-71 N PARISH RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-2914
Mailing Address - Country:US
Mailing Address - Phone:978-722-8391
Mailing Address - Fax:978-681-5209
Practice Address - Street 1:70-71 N PARISH RD
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-2914
Practice Address - Country:US
Practice Address - Phone:978-722-8391
Practice Address - Fax:978-681-5209
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-18
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2764133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered