Provider Demographics
NPI:1417389677
Name:HAW, JOANN (RD LD)
Entity Type:Individual
Prefix:MRS
First Name:JOANN
Middle Name:
Last Name:HAW
Suffix:
Gender:F
Credentials:RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7974 PRINCEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-1590
Mailing Address - Country:US
Mailing Address - Phone:330-801-5339
Mailing Address - Fax:
Practice Address - Street 1:7974 PRINCEWOOD DR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-1590
Practice Address - Country:US
Practice Address - Phone:330-801-5339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.1190133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered