Provider Demographics
NPI:1639639032
Name:CECH, SUSAN CHRISTINE (RD,LD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:CHRISTINE
Last Name:CECH
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 1:1516 GREENFIELD LN
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-6116
Mailing Address - Country:US
Mailing Address - Phone:216-374-5732
Mailing Address - Fax:
Practice Address - Street 1:1516 GREENFIELD LN
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-6116
Practice Address - Country:US
Practice Address - Phone:216-374-5732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD3731133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered