Provider Demographics
NPI:1205008158
Name:FRALE-KLOUDA, ANDREA JOAN (RD MPH CCN LDN)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:JOAN
Last Name:FRALE-KLOUDA
Suffix:
Gender:F
Credentials:RD MPH CCN LDN
Other - Prefix:MS
Other - First Name:ANDREA
Other - Middle Name:JOAN
Other - Last Name:FRALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:614 HICKORY STREET
Mailing Address - Street 2:
Mailing Address - City:SUGAR GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60554-9302
Mailing Address - Country:US
Mailing Address - Phone:630-885-7907
Mailing Address - Fax:630-466-1971
Practice Address - Street 1:614 HICKORY STREET
Practice Address - Street 2:
Practice Address - City:SUGAR GROVE
Practice Address - State:IL
Practice Address - Zip Code:60554-9302
Practice Address - Country:US
Practice Address - Phone:630-885-7907
Practice Address - Fax:630-466-1971
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered