Provider Demographics
NPI:1932519022
Name:COHEN, LINDSAY (RD, LD)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:H
Other - Last Name:FARB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:PO BOX 23340
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63156-3340
Mailing Address - Country:US
Mailing Address - Phone:314-838-5702
Mailing Address - Fax:314-839-5596
Practice Address - Street 1:1225 GRAHAM RD BLDG C
Practice Address - Street 2:STE 1330
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-8012
Practice Address - Country:US
Practice Address - Phone:314-838-5702
Practice Address - Fax:314-839-5596
Is Sole Proprietor?:No
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010028866133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered