Provider Demographics
NPI:1821522046
Name:HINCK, SUZANNE (RDN)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:
Last Name:HINCK
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 1:3282 CLARENDON RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-4252
Mailing Address - Country:US
Mailing Address - Phone:612-812-6674
Mailing Address - Fax:
Practice Address - Street 1:30625 SOLON RD
Practice Address - Street 2:SUITE C
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-3472
Practice Address - Country:US
Practice Address - Phone:216-378-0888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-13
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.7674133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered