Provider Demographics
NPI:1912547548
Name:MENKEN, LAURA DICKENS (MS RDN LDN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:DICKENS
Last Name:MENKEN
Suffix:
Gender:F
Credentials:MS RDN LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 WILMINGTON W CHESTER PIKE STE 200
Mailing Address - Street 2:
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-9011
Mailing Address - Country:US
Mailing Address - Phone:610-637-2206
Mailing Address - Fax:610-227-6109
Practice Address - Street 1:225 WILMINGTON W CHESTER PIKE
Practice Address - Street 2:SUITE 200 - #300
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-9011
Practice Address - Country:US
Practice Address - Phone:610-637-2206
Practice Address - Fax:610-227-6109
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-12
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN006930133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered