Healthcare Provider Details

I. General information

NPI: 1548924723
Provider Name (Legal Business Name): ALAINA LOPEZ RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2021
Last Update Date: 10/29/2021
Certification Date: 10/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 PIEDMONT AVE STE 5400
CINCINNATI OH
45219-4241
US

IV. Provider business mailing address

7690 DISCOVERY DR UNIT 1600
WEST CHESTER OH
45069-6559
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-8091
  • Fax: 513-475-7348
Mailing address:
  • Phone: 513-475-8840
  • Fax: 513-874-4579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD6877
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: