Provider Demographics
NPI:1235412792
Name:SCHWARTZ, KELLI ANN (MS,RD,LD)
Entity Type:Individual
Prefix:MRS
First Name:KELLI
Middle Name:ANN
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:MS,RD,LD
Other - Prefix:MS
Other - First Name:KELLI
Other - Middle Name:ANN
Other - Last Name:RAKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,RD,LD
Mailing Address - Street 1:6350 E GALBRAITH RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2354
Mailing Address - Country:US
Mailing Address - Phone:513-686-6820
Mailing Address - Fax:513-686-6819
Practice Address - Street 1:6350 E GALBRAITH RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2354
Practice Address - Country:US
Practice Address - Phone:513-686-6820
Practice Address - Fax:513-686-6819
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5151133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered