Provider Demographics
NPI:1831868025
Name:SEARLES, JENNIFER (MS, RDN, LD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:SEARLES
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6351 TIMBERS CT
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-7722
Mailing Address - Country:US
Mailing Address - Phone:513-407-1751
Mailing Address - Fax:
Practice Address - Street 1:6351 TIMBERS CT
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-7722
Practice Address - Country:US
Practice Address - Phone:513-407-1751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.09433133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered