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General NPI Number Information
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NPI Number | 1811466410
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Entity Type | Organization
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Legal Business Name | LAUREN NEWMAN NUTRITION THERAPY LLC
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Dates
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Enumeration Date | 11/13/2018
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 2306 LAKE AUSTIN BLVD
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City | AUSTIN
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State | TX
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Zip | 78703-4546
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Country | US
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Telephone | 201-394-9833
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 SIMOND AVE APT 2065
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City | AUSTIN
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State | TX
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Zip | 78723-4653
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAUREN NEWMAN
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Credential | RD, LD
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Telephone | 201-394-9833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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