Provider Demographics
NPI:1952727794
Name:CHELNICK, CHARLENE (RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:CHARLENE
Middle Name:
Last Name:CHELNICK
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 1:6915 SILKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-5079
Mailing Address - Country:US
Mailing Address - Phone:440-248-2558
Mailing Address - Fax:
Practice Address - Street 1:6915 SILKWOOD LN
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-5079
Practice Address - Country:US
Practice Address - Phone:440-785-9096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD 2389133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered