Provider Demographics
NPI:1356962203
Name:HOOPER, LUCY PRICE (RD)
Entity type:Individual
Prefix:MS
First Name:LUCY
Middle Name:PRICE
Last Name:HOOPER
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 1:507 QUEENS RD APT 405
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-1592
Mailing Address - Country:US
Mailing Address - Phone:276-734-5667
Mailing Address - Fax:
Practice Address - Street 1:507 QUEENS RD APT 405
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1592
Practice Address - Country:US
Practice Address - Phone:276-734-5667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC86085594133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered