Provider Demographics
NPI:1790389690
Name:SCHOEN, SOPHIE (RD, LDN)
Entity Type:Individual
Prefix:
First Name:SOPHIE
Middle Name:
Last Name:SCHOEN
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3379 GREEN RD
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4050
Mailing Address - Country:US
Mailing Address - Phone:216-346-7630
Mailing Address - Fax:
Practice Address - Street 1:25200 CHAGRIN BLVD STE 110
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5685
Practice Address - Country:US
Practice Address - Phone:216-328-8086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.09169133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered