Provider Demographics
NPI:1225037088
Name:BOND, TAMARA L (MS, RD, LD)
Entity Type:Individual
Prefix:MS
First Name:TAMARA
Middle Name:L
Last Name:BOND
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 1:8001 COLONIAL DR
Mailing Address - Street 2:UNIT C
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-9379
Mailing Address - Country:US
Mailing Address - Phone:440-667-9264
Mailing Address - Fax:
Practice Address - Street 1:8001 COLONIAL DR
Practice Address - Street 2:UNIT C
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-9379
Practice Address - Country:US
Practice Address - Phone:440-667-9264
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4310133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered