Provider Demographics
NPI:1306401815
Name:FLAHIVE, CHELSEA GOODSELL (RD, LD)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:GOODSELL
Last Name:FLAHIVE
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:NICOLE
Other - Last Name:GOODSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-3611
Mailing Address - Fax:513-636-5887
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:ML 5043
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-3611
Practice Address - Fax:513-636-5887
Is Sole Proprietor?:No
Enumeration Date:2019-05-09
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH390200000X390200000X
OHLD.7261133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program