Provider Demographics
NPI:1841200185
Name:CLEVEN, MARY LOUISE (MS, RD)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:LOUISE
Last Name:CLEVEN
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5500 ARMSTRONG RD
Mailing Address - Street 2:VA MEDICAL CENTER BLD 5
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-1014
Mailing Address - Country:US
Mailing Address - Phone:269-223-5383
Mailing Address - Fax:269-223-5054
Practice Address - Street 1:5500 ARMSTRONG RD
Practice Address - Street 2:VA MEDICAL CENTER BLD 5
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-1014
Practice Address - Country:US
Practice Address - Phone:269-223-5383
Practice Address - Fax:269-223-5054
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered