Provider Demographics
NPI:1649000845
Name:STAHELI, MEGAN (RD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:STAHELI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 E HOLLOW DALE DR
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD HEIGHTS
Mailing Address - State:UT
Mailing Address - Zip Code:84121-2707
Mailing Address - Country:US
Mailing Address - Phone:435-705-8960
Mailing Address - Fax:
Practice Address - Street 1:7050 S HIGHLAND DR STE 310
Practice Address - Street 2:
Practice Address - City:COTTONWOOD HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84121-3760
Practice Address - Country:US
Practice Address - Phone:801-996-3414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-03
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12482238-4901133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty