Provider Demographics
NPI:1467682401
Name:LIPOWSKI, JULIE A (RD, LD)
Entity Type:Individual
Prefix:MISS
First Name:JULIE
Middle Name:A
Last Name:LIPOWSKI
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 1:25550 CHAGRIN BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5638
Mailing Address - Country:US
Mailing Address - Phone:216-765-0500
Mailing Address - Fax:216-765-0521
Practice Address - Street 1:25550 CHAGRIN BLVD
Practice Address - Street 2:STE 200
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5638
Practice Address - Country:US
Practice Address - Phone:216-765-0500
Practice Address - Fax:216-765-0521
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-24
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.5545133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered