Provider Demographics
NPI:1376789503
Name:SEIP, STARR MICHELLE (PHD MS RD LDN CDE)
Entity Type:Individual
Prefix:MRS
First Name:STARR
Middle Name:MICHELLE
Last Name:SEIP
Suffix:
Gender:F
Credentials:PHD MS RD LDN CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1432 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:PINE GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17963-8695
Mailing Address - Country:US
Mailing Address - Phone:570-617-3650
Mailing Address - Fax:570-345-2034
Practice Address - Street 1:1432 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:PINE GROVE
Practice Address - State:PA
Practice Address - Zip Code:17963-8695
Practice Address - Country:US
Practice Address - Phone:570-617-3650
Practice Address - Fax:570-345-2034
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-17
Last Update Date:2019-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN001424133VN1006X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic