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General NPI Number Information
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NPI Number | 1770780249
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Entity Type | Individual
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Provider Name | CLAUDIA E HUMPHREY R.D., L.D., C.D.E.
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Gender | Female
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3009 N BALLAS RD STE 216B
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City | SAINT LOUIS
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State | MO
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Zip | 63131-2308
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Country | US
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Telephone | 314-996-4352
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Fax | 314-996-4591
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Provider Business Mailing Address
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Address Line | 15454 LONG CASTLE FOREST CT
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City | CHESTERFIELD
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State | MO
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Zip | 63017-7447
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Country | US
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Telephone | 636-532-2953
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Fax | 636-532-2953
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 2001023549
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License Number State | MO
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