Provider Demographics
NPI:1598501611
Name:LABORANTI, LYNN M (MS, RDN)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:M
Last Name:LABORANTI
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 HIDEAWAY DR
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:PA
Mailing Address - Zip Code:18444-5102
Mailing Address - Country:US
Mailing Address - Phone:570-499-7838
Mailing Address - Fax:
Practice Address - Street 1:606 HIDEAWAY DR
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:PA
Practice Address - Zip Code:18444-5102
Practice Address - Country:US
Practice Address - Phone:570-499-7838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA831484133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered