Provider Demographics
NPI:1851285571
Name:MOHLER, SAMANTHA (RD, CSO, LD)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:MOHLER
Suffix:
Gender:F
Credentials:RD, CSO, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5755 CORRAL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-0030
Mailing Address - Country:US
Mailing Address - Phone:614-905-6762
Mailing Address - Fax:
Practice Address - Street 1:5755 CORRAL CREEK DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-0030
Practice Address - Country:US
Practice Address - Phone:614-905-6762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.09304133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered