Basic Information
| Provider Information | |||||||||
| NPI: | 1548544844 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FOREMAN | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | GIGLIO | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4212 W CONGRESS ST STE 2300A | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705066778 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3372377801 | ||||||||
| FaxNumber: | 3372351865 | ||||||||
| Practice Location | |||||||||
| Address1: | 4212 W CONGRESS ST STE 2300A | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705066778 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3372377801 | ||||||||
| FaxNumber: | 3372351865 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2011 | ||||||||
| LastUpdateDate: | 07/30/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 2044 | LA | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.