Provider Demographics
NPI:1467692152
Name:STEHLIK, CAROL A (RD, LD, MBA, LMNT)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:A
Last Name:STEHLIK
Suffix:
Gender:F
Credentials:RD, LD, MBA, LMNT
Other - Prefix:MRS
Other - First Name:CAROL
Other - Middle Name:A
Other - Last Name:HAUGEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 PERSHING AVENUE
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:IA
Mailing Address - Zip Code:51601-0382
Mailing Address - Country:US
Mailing Address - Phone:712-246-1230
Mailing Address - Fax:712-246-7357
Practice Address - Street 1:300 PERSHING AVENUE
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:IA
Practice Address - Zip Code:51601-0382
Practice Address - Country:US
Practice Address - Phone:712-246-1230
Practice Address - Fax:712-246-7357
Is Sole Proprietor?:No
Enumeration Date:2009-02-20
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001809133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education