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WESTERN RESERVE NUTRITION NPI 1356883474


NPI Information

NPI: 1356883474
Provider Name: WESTERN RESERVE NUTRITION
Classification: Dietitian, Registered - 133V00000X
Entity Type: Organization

CLIA Number: 36D0876809

Address:
9205 STATE ROUTE 43 STE 106
STREETSBORO, OH
ZIP 44241
Phone: (330) 554-9327
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WESTERN RESERVE NUTRITION is a dietitian registered in Streetsboro, OH. The provider is a Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation. WESTERN RESERVE NUTRITION NPI is 1356883474. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9205 STATE ROUTE 43 STE 106
STREETSBORO, OH
ZIP 44241-366
Phone: (330) 554-9327
Fax: (330) 294-5651

The provider's authorized official is Carolyn Joseph Bouquot .
The authorized official title is Owner and has the following contact phone number (330) 554-9327.

The CLIA number assigned to this NPI record is 36D0876809 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/7/2016 and was last updated on 11/12/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1133V00000XDietitian, Registered4344OHIOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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