Provider Demographics
NPI:1922645357
Name:O'HARA, LAURA HEDRICK (MS, RD, LD)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:HEDRICK
Last Name:O'HARA
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3209 BROOKHOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-5201
Mailing Address - Country:US
Mailing Address - Phone:214-364-0620
Mailing Address - Fax:
Practice Address - Street 1:4629 NW 23RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-2103
Practice Address - Country:US
Practice Address - Phone:214-364-0620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-04
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2425133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered