Provider Demographics
NPI:1902004021
Name:SCHREIN, KATHLEEN L (RDLD)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:L
Last Name:SCHREIN
Suffix:
Gender:F
Credentials:RDLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066-1106
Mailing Address - Country:US
Mailing Address - Phone:937-208-7100
Mailing Address - Fax:937-208-7125
Practice Address - Street 1:360 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SPRINGBORO
Practice Address - State:OH
Practice Address - Zip Code:45066-1106
Practice Address - Country:US
Practice Address - Phone:937-208-7100
Practice Address - Fax:937-208-7125
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.1023133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered