Provider Demographics
NPI:1194343137
Name:STROBEL, LAINE WALKER (RD)
Entity type:Individual
Prefix:
First Name:LAINE
Middle Name:WALKER
Last Name:STROBEL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17688 WESTHAMPTON WOODS DR
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-6332
Mailing Address - Country:US
Mailing Address - Phone:636-751-6472
Mailing Address - Fax:
Practice Address - Street 1:17688 WESTHAMPTON WOODS DR
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:MO
Practice Address - Zip Code:63005-6332
Practice Address - Country:US
Practice Address - Phone:636-751-6472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered