Provider Demographics
NPI:1902527393
Name:EDEN, LAUREN RACHEL
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:RACHEL
Last Name:EDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7171 WOODMONT AVE UNIT 404
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20815-6275
Mailing Address - Country:US
Mailing Address - Phone:301-908-0011
Mailing Address - Fax:
Practice Address - Street 1:7171 WOODMONT AVE UNIT 404
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20815-6275
Practice Address - Country:US
Practice Address - Phone:301-908-0011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education