Provider Demographics
NPI:1386152106
Name:LEHNER-GULOTTA, DIANA (RDN, CNSC)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:
Last Name:LEHNER-GULOTTA
Suffix:
Gender:F
Credentials:RDN, CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:859 OLD BROOK RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-1776
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:859 OLD BROOK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1776
Practice Address - Country:US
Practice Address - Phone:434-297-7221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-15
Last Update Date:2018-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86079894133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
86079894OtherACADEMY OF NUTRITION AND DIETETICS
7765560OtherTHE NATIONAL BOARD OF NUTRITION SUPPORT CERTIFICATION