Provider Demographics
NPI:1700496460
Name:MCHUGH, KELCI MARIE (RD)
Entity Type:Individual
Prefix:
First Name:KELCI
Middle Name:MARIE
Last Name:MCHUGH
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 1:100 HENRICK DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-5433
Mailing Address - Country:US
Mailing Address - Phone:513-594-3917
Mailing Address - Fax:
Practice Address - Street 1:100 HENRICK DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-5433
Practice Address - Country:US
Practice Address - Phone:513-594-3917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.08952133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered