Healthcare Provider Details

I. General information

NPI: 1871840090
Provider Name (Legal Business Name): RACHEL LAYMON RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2012
Last Update Date: 05/12/2020
Certification Date: 05/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25200 CHAGRIN BLVD STE 109
BEACHWOOD OH
44122-5681
US

IV. Provider business mailing address

25200 CHAGRIN BLVD STE 109
BEACHWOOD OH
44122-5681
US

V. Phone/Fax

Practice location:
  • Phone: 216-772-4653
  • Fax:
Mailing address:
  • Phone: 216-772-4653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number6692
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: