Provider Demographics
NPI:1184970030
Name:GUIDRY, SONIA A (LDN, RD)
Entity type:Individual
Prefix:MRS
First Name:SONIA
Middle Name:A
Last Name:GUIDRY
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 1:201 IVORY ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-5755
Mailing Address - Country:US
Mailing Address - Phone:337-739-9401
Mailing Address - Fax:
Practice Address - Street 1:220 W WILLOW ST
Practice Address - Street 2:BLDG A
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-2837
Practice Address - Country:US
Practice Address - Phone:337-262-5616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1799133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered