Provider Demographics
NPI:1750792594
Name:DIMATTIO, JAIME MICHELLE (RD,LD)
Entity type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:MICHELLE
Last Name:DIMATTIO
Suffix:
Gender:F
Credentials:RD,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-444-5329
Mailing Address - Fax:216-445-1521
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-6053
Practice Address - Country:US
Practice Address - Phone:216-444-5329
Practice Address - Fax:216-445-1521
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.7394133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered