Provider Demographics
NPI:1922274331
Name:MARSH, STACIE DUCOTE (LDN, RD)
Entity Type:Individual
Prefix:MRS
First Name:STACIE
Middle Name:DUCOTE
Last Name:MARSH
Suffix:
Gender:F
Credentials:LDN, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 WILLIAM GUILLORY RD
Mailing Address - Street 2:
Mailing Address - City:PLAUCHEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71362-2742
Mailing Address - Country:US
Mailing Address - Phone:318-922-3301
Mailing Address - Fax:318-922-3308
Practice Address - Street 1:223 WILLIAM GUILLORY RD
Practice Address - Street 2:
Practice Address - City:PLAUCHEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71362-2742
Practice Address - Country:US
Practice Address - Phone:318-922-3301
Practice Address - Fax:318-922-3308
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1743133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered