Provider Demographics
NPI:1720831423
Name:RAYMOND, BRIANA (RD, LDN)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3424 CROSSHILL DR
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-4112
Mailing Address - Country:US
Mailing Address - Phone:419-889-1165
Mailing Address - Fax:
Practice Address - Street 1:220 W MARKET ST STE 102
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-4820
Practice Address - Country:US
Practice Address - Phone:567-525-2393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.09616133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered