Provider Demographics
NPI:1336694975
Name:HOOVER, CHELSEA (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:HOOVER
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2917 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-1129
Mailing Address - Country:US
Mailing Address - Phone:484-515-5883
Mailing Address - Fax:
Practice Address - Street 1:2917 POPLAR ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-1129
Practice Address - Country:US
Practice Address - Phone:484-515-5883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN005973133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered