Provider Demographics
NPI:1205916244
Name:BANDER, DANA L (MPH, RD, LD, CDCES)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:L
Last Name:BANDER
Suffix:
Gender:F
Credentials:MPH, RD, LD, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4180 WARRENSVILLE CENTER RD BLDG 6TH
Mailing Address - Street 2:
Mailing Address - City:WARRENSVILLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-7024
Mailing Address - Country:US
Mailing Address - Phone:216-491-7434
Mailing Address - Fax:
Practice Address - Street 1:4180 WARRENSVILLE CENTER RD BLDG 6TH
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-7024
Practice Address - Country:US
Practice Address - Phone:216-491-7434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRD697491133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered