Mallory Morton, RDN, LDN

Individual provider Active NPI Registered Dietitian · Olla, LA

NPI 1376019257 · NPPES record last updated Oct 18, 2018

Key facts

NPI
1376019257
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
2588 (LA)
Practice address
1102 N Pine Rd
Olla, LA 71465-4804
Phone
(318) 495-3131
Fax
(318) 495-3229
NPI assigned
Oct 18, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2588 LA Yes

Addresses

Primary practice location

1102 N Pine Rd
Olla, LA 71465-4804

Mailing address

1809 E Georgia Ave
Ruston, LA 71270-4062
Phone (318) 471-8898

Other providers in Olla, LA

All providers in Olla, LA · Registered Dietitian in Louisiana

Sources for this page

Verify at the official NPI Registry.