Provider Demographics
NPI:1902358898
Name:LAMBOLEY, CATHERINE (RDN)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:LAMBOLEY
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 W 24TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-8705
Mailing Address - Country:US
Mailing Address - Phone:928-329-8331
Mailing Address - Fax:928-329-8528
Practice Address - Street 1:1220 W 24TH ST STE 1
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8705
Practice Address - Country:US
Practice Address - Phone:928-329-8331
Practice Address - Fax:928-329-8528
Is Sole Proprietor?:No
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL851621133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered