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General NPI Number Information
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NPI Number | 1508673146
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Entity Type | Individual
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Provider Name | SHAUNTRA LAMOTTE - OSBORNE BCHHP, CHN
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Gender | Female
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Dates
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Enumeration Date | 12/17/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 2232 DELL RANGE BLVD SUITE 245 BOX# 3317
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City | CHEYENNE
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State | WY
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Zip | 82009
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Country | US
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Telephone | 973-517-0182
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Fax |
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Provider Business Mailing Address
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Address Line | 2232 DELL RANGE BLVD SUITE 245 BOX# 3317
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City | CHEYENNE
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State | WY
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Zip | 82009
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Country | US
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Telephone | 973-517-0182
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 115535979
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 115535979
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License Number State |
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