Provider Demographics
NPI:1396436226
Name:HAIS, EMILY RENEE (RD, LD, CLC)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:RENEE
Last Name:HAIS
Suffix:
Gender:F
Credentials:RD, LD, CLC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:RENEE
Other - Last Name:MCMAHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:457 LYNESS AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:OH
Mailing Address - Zip Code:45030-5008
Mailing Address - Country:US
Mailing Address - Phone:513-509-9408
Mailing Address - Fax:
Practice Address - Street 1:457 LYNESS AVE
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:OH
Practice Address - Zip Code:45030-5008
Practice Address - Country:US
Practice Address - Phone:513-509-9408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.8052133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered