Provider Demographics
NPI:1700411428
Name:NEWLOVE-CHIMES, TAYLOR (RDN)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:NEWLOVE-CHIMES
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3559 ELM BROOK DR
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-2026
Mailing Address - Country:US
Mailing Address - Phone:419-356-9473
Mailing Address - Fax:
Practice Address - Street 1:3559 ELM BROOK DR
Practice Address - Street 2:
Practice Address - City:BROADVIEW HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44147-2026
Practice Address - Country:US
Practice Address - Phone:419-356-9473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.08381133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered