Provider Demographics
NPI:1043598766
Name:FRISWOLD, JANICE (RD LD CDE)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:FRISWOLD
Suffix:
Gender:F
Credentials:RD LD CDE
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:
Other - Last Name:HERTZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11100 EUCLID AVE
Mailing Address - Street 2:MAILSTOP LKSD 5021
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1716
Mailing Address - Country:US
Mailing Address - Phone:216-844-1058
Mailing Address - Fax:216-844-0226
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:MAILSTOP LKSD 5021
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-1058
Practice Address - Fax:216-844-0226
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
550460133V00000X
OH1327133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered