Provider Demographics
NPI:1285855023
Name:LOOSE, CLAIRE C (MA, RD, LD)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:C
Last Name:LOOSE
Suffix:
Gender:F
Credentials:MA, RD, LD
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:
Other - Last Name:ADKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 WABASH AVENUE
Mailing Address - Street 2:FOOD & NUTRITION SERVICES
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44307
Mailing Address - Country:US
Mailing Address - Phone:330-344-6122
Mailing Address - Fax:330-344-1618
Practice Address - Street 1:400 WABASH AVENUE
Practice Address - Street 2:FOOD & NUTRITION SERVICES
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307
Practice Address - Country:US
Practice Address - Phone:330-344-6122
Practice Address - Fax:330-344-1618
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH891133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered