Provider Demographics
NPI:1437348356
Name:ASSAD, LORI A (RD, LD)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:A
Last Name:ASSAD
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 1:80 DEVON LN
Mailing Address - Street 2:UNIT 203
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-6851
Mailing Address - Country:US
Mailing Address - Phone:330-808-1471
Mailing Address - Fax:
Practice Address - Street 1:80 DEVON LN
Practice Address - Street 2:UNIT 203
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-6851
Practice Address - Country:US
Practice Address - Phone:330-808-1471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2014-01-28
Deactivation Date:2013-01-08
Deactivation Code:
Reactivation Date:2014-01-28
Provider Licenses
StateLicense IDTaxonomies
OH972535133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered