Healthcare Provider Details

I. General information

NPI: 1285855023
Provider Name (Legal Business Name): CLAIRE C LOOSE MA, RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CLAIRE ADKINS

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 05/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 WABASH AVENUE FOOD & NUTRITION SERVICES
AKRON OH
44307
US

IV. Provider business mailing address

400 WABASH AVENUE FOOD & NUTRITION SERVICES
AKRON OH
44307
US

V. Phone/Fax

Practice location:
  • Phone: 330-344-6122
  • Fax: 330-344-1618
Mailing address:
  • Phone: 330-344-6122
  • Fax: 330-344-1618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number891
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: