Provider Demographics
NPI:1609956747
Name:DASH, SHIRLEY PATTERSON (RD/LD)
Entity Type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:PATTERSON
Last Name:DASH
Suffix:
Gender:F
Credentials:RD/LD
Other - Prefix:MRS
Other - First Name:SHIRLEY
Other - Middle Name:PATTERSON
Other - Last Name:WILKES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD LD
Mailing Address - Street 1:19298 TRILLIUM TRAIL
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44149-3146
Mailing Address - Country:US
Mailing Address - Phone:440-572-1190
Mailing Address - Fax:
Practice Address - Street 1:7007 POWERS BLVD
Practice Address - Street 2:PARMA COMMUNITY GENERAL HOSPITAL
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-4495
Practice Address - Country:US
Practice Address - Phone:440-743-2150
Practice Address - Fax:440-743-2280
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH177133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered