Healthcare Provider Details

I. General information

NPI: 1134565641
Provider Name (Legal Business Name): DEMA HALASA ESPER MS, RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2013
Last Update Date: 05/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 TIMBER RUN DR.
CANFIELD OH
44406
US

IV. Provider business mailing address

52 TIMBER RUN DR.
CANFIELD OH
44406
US

V. Phone/Fax

Practice location:
  • Phone: 330-519-6860
  • Fax: 330-533-2932
Mailing address:
  • Phone: 330-519-6860
  • Fax: 330-533-2932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD:6231
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: