Provider Demographics
NPI:1215290960
Name:LORENZO, LAUREN LYNCH (MS, RD, LD)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:LYNCH
Last Name:LORENZO
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 KENLEY CT
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-5100
Mailing Address - Country:US
Mailing Address - Phone:404-803-1465
Mailing Address - Fax:
Practice Address - Street 1:5825 GLENRIDGE DR NE
Practice Address - Street 2:BLDG. 2, SUITE 107
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-5387
Practice Address - Country:US
Practice Address - Phone:404-736-6287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD003904133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered