Provider Demographics
NPI:1821808726
Name:HALL, LAURA MARIE (PHD, RDN)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:MARIE
Last Name:HALL
Suffix:
Gender:F
Credentials:PHD, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 MAHAFFEY CT
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-7333
Mailing Address - Country:US
Mailing Address - Phone:916-216-6919
Mailing Address - Fax:
Practice Address - Street 1:1616 MAHAFFEY CT
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-7333
Practice Address - Country:US
Practice Address - Phone:916-216-6919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered