Provider Demographics
NPI:1942901665
Name:LINDER, MICHELLE LOUISE (RDN)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:LOUISE
Last Name:LINDER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:MISS
Other - First Name:MICHELLE
Other - Middle Name:LOUISE
Other - Last Name:KUTYBA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:1554 PEACHTREE AVE SW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-1033
Mailing Address - Country:US
Mailing Address - Phone:513-939-6148
Mailing Address - Fax:
Practice Address - Street 1:1554 PEACHTREE AVE SW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-1033
Practice Address - Country:US
Practice Address - Phone:513-939-6148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD5860133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty