Provider Demographics
NPI:1881245520
Name:LAW, ALEXIS (RDN, LDN)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:LAW
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:CASE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN, LDN
Mailing Address - Street 1:620 W MACPHAIL RD STE 102
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4474
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:620 W MACPHAIL RD STE 102
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4474
Practice Address - Country:US
Practice Address - Phone:443-819-3648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-24
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX4808133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered