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General NPI Number Information
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NPI Number | 1003020884
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Entity Type | Individual
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Provider Name | CATHLEEN B MCLACHLAN
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Gender | Female
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 06/24/2013
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Provider Practice Location Address
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Address Line | 1 TITUS PL
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City | WALTON
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State | NY
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Zip | 13856-1457
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Country | US
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Telephone | 607-865-2159
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Fax |
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Provider Business Mailing Address
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Address Line | 1 TITUS PL
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City | WALTON
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State | NY
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Zip | 13856-1457
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Country | US
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Telephone | 607-865-2100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 004612-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 136A00000X
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Taxonomy Name | Registered Dietetic Technician
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License Number | 714205
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License Number State | NY
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