Individual
LACEY MCDONOUGH RABURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, CLC, LDN
Contact information
Practice address
3234 MILLER AVE, CROSSVILLE, TN 38555-6116
(931) 707-8700
Mailing address
3234 MILLER AVE, CROSSVILLE, TN 38555-6116
(931) 707-8700
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LDN0000002414
TN
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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