Individual
MS. LARAINE DELL WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD LD LPN
Contact information
Practice address
26799 OWENS DR, LEBANON, MO 65536-9380
(417) 532-9411
Mailing address
9521 N AMBASSADOR DR. APT 3104, KANSAS CITY, MO 64154
(417) 718-1218
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2005030875
MO
Other
Enumeration date
06/10/2006
Last updated
09/02/2021
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