Provider Demographics
NPI:1356528202
Name:CONTEH, LAURIE MICHELLE (RD)
Entity type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:MICHELLE
Last Name:CONTEH
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 CAPSTONE DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-5846
Mailing Address - Country:US
Mailing Address - Phone:919-210-8497
Mailing Address - Fax:
Practice Address - Street 1:3419 HILLSBOROUGH RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3008
Practice Address - Country:US
Practice Address - Phone:919-210-8497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC968605133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered