Provider Demographics
NPI:1255418257
Name:ABRAMSON, MINDY UDELL (MS, RD, LD)
Entity type:Individual
Prefix:MRS
First Name:MINDY
Middle Name:UDELL
Last Name:ABRAMSON
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5627 DIANNE CT
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-1076
Mailing Address - Country:US
Mailing Address - Phone:419-472-9174
Mailing Address - Fax:419-472-9174
Practice Address - Street 1:5627 DIANNE CT
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-1076
Practice Address - Country:US
Practice Address - Phone:419-472-9174
Practice Address - Fax:419-472-9174
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1223133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered