Provider Demographics
NPI:1275845463
Name:ROOD, ROBIN S (MED RD LD)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:S
Last Name:ROOD
Suffix:
Gender:F
Credentials:MED RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5192 CHILLICOTHE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-4196
Mailing Address - Country:US
Mailing Address - Phone:440-338-3366
Mailing Address - Fax:440-338-3332
Practice Address - Street 1:5192 CHILLICOTHE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44022-4196
Practice Address - Country:US
Practice Address - Phone:440-338-3366
Practice Address - Fax:440-338-3332
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-05
Last Update Date:2010-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH684646133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered