Provider Demographics
NPI:1720222482
Name:STANFAR, KAREN LOUISE (MPH, RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LOUISE
Last Name:STANFAR
Suffix:
Gender:F
Credentials:MPH, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11925 PEARL RD
Mailing Address - Street 2:SUITE 402
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-3353
Mailing Address - Country:US
Mailing Address - Phone:440-238-4441
Mailing Address - Fax:440-374-7178
Practice Address - Street 1:11925 PEARL RD
Practice Address - Street 2:SUITE 402
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-3353
Practice Address - Country:US
Practice Address - Phone:440-238-4441
Practice Address - Fax:440-374-7178
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-25
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2319133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered