Provider Demographics
NPI:1497166524
Name:KLUCINEC, MEGAN (RD, LDN, CDE)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:
Last Name:KLUCINEC
Suffix:
Gender:F
Credentials:RD, LDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 CENTER NEW TEXAS RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15239-1820
Mailing Address - Country:US
Mailing Address - Phone:412-828-9798
Mailing Address - Fax:
Practice Address - Street 1:556 PITTSBURGH MILLS CIRCLE
Practice Address - Street 2:DESTINATION WELLNESS
Practice Address - City:TARENTUM
Practice Address - State:PA
Practice Address - Zip Code:15084
Practice Address - Country:US
Practice Address - Phone:724-274-5208
Practice Address - Fax:724-274-5210
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN001965133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic