Provider Demographics
NPI:1124374095
Name:ANELLO, MEGAN AILEEN (MS,RD,LD,)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:AILEEN
Last Name:ANELLO
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 1:4750 WESLEY AVE STE J
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2276
Mailing Address - Country:US
Mailing Address - Phone:513-531-5110
Mailing Address - Fax:513-531-5668
Practice Address - Street 1:4750 WESLEY AVE STE J
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-2276
Practice Address - Country:US
Practice Address - Phone:513-531-5110
Practice Address - Fax:513-531-5668
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4191133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered