Provider Demographics
NPI:1235695602
Name:PARRISH, LAUREN (MS, RD, CSSD, CEDS)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:PARRISH
Suffix:
Gender:
Credentials:MS, RD, CSSD, CEDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5895 S KINGSTON WAY
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-6144
Mailing Address - Country:US
Mailing Address - Phone:641-799-9048
Mailing Address - Fax:
Practice Address - Street 1:515 S 700 E STE 2D
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-2858
Practice Address - Country:US
Practice Address - Phone:913-274-9252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-11
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13489629-4901133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered