Provider Demographics
NPI:1952009359
Name:HANDORF, SHERIDAN (RD)
Entity Type:Individual
Prefix:
First Name:SHERIDAN
Middle Name:
Last Name:HANDORF
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:SHERIDAN
Other - Middle Name:
Other - Last Name:JONAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4440 RED BANK RD STE 210
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-2177
Mailing Address - Country:US
Mailing Address - Phone:513-564-3952
Mailing Address - Fax:
Practice Address - Street 1:4440 RED BANK RD STE 210
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-2177
Practice Address - Country:US
Practice Address - Phone:513-564-3952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHD.08760133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHLD.08760OtherSTATE MEDICAL BOARD OF OHIO
KY269145OtherKENTUCKY BOARD OF LICENSURE AND CERTIFICATION FOR DIETITIANS AND NUTRITIONISTS