Doctor Name: | LACY MAQUEL PUTTUCK |
NPI Number: | 1366719312 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.D. |
License Number: | |
Business Practice Address: | 6445 S Tenaya Way Ste 160 Las Vegas, NV - 891131991 |
Business Phone Number: | 7025673495 |
Business Fax Number: | |
Mailing Address: | 6445 S Tenaya Way Ste 160, LAS VEGAS |
State: | NV |
Postal Code: | 891131991 |
Phone Number: | 7025673495 |
Fax Number: | |
NPI Enumeration Date: | 11/18/2011 |
NPI Last Update Date: | 02/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |