Basic Information
Provider Information
NPI: 1366691776
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAVOIE
FirstName: PAULA
MiddleName: L
NamePrefix: MRS.
NameSuffix:  
Credential: R.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1389
Address2:  
City: OPELOUSAS
State: LA
PostalCode: 705711389
CountryCode: US
TelephoneNumber: 3379483011
FaxNumber: 3374078623
Practice Location
Address1: 539 E PRUDHOMME ST
Address2:  
City: OPELOUSAS
State: LA
PostalCode: 705706499
CountryCode: US
TelephoneNumber: 3379483011
FaxNumber: 3374078623
Other Information
ProviderEnumerationDate: 09/10/2008
LastUpdateDate: 09/10/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
133V00000X194LAY Dietary & Nutritional Service ProvidersDietitian, Registered 

No ID Information.


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