Basic Information
| Provider Information | |||||||||
| NPI: | 1649741752 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHAEFER | ||||||||
| FirstName: | CHELSEA | ||||||||
| MiddleName: | |||||||||
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| Credential: | MFN, RD, LD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4075 W DUBLIN GRANVILLE RD | ||||||||
| Address2: | |||||||||
| City: | DUBLIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430171436 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6143564079 | ||||||||
| FaxNumber: | 6142100565 | ||||||||
| Practice Location | |||||||||
| Address1: | 4075 W DUBLIN GRANVILLE RD | ||||||||
| Address2: | |||||||||
| City: | DUBLIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430171436 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6143564079 | ||||||||
| FaxNumber: | 6142100565 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2018 | ||||||||
| LastUpdateDate: | 12/16/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 86003425 | OH | Y | 193200000X MULTI-SPECIALTY GROUP | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.