Healthcare Provider Details

I. General information

NPI: 1093491920
Provider Name (Legal Business Name): ERIN HAWLEY MS, RDN, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDREN PLAZA
DAYTON OH
45404
US

IV. Provider business mailing address

8264 MELLON DR.
MONTGOMERY OH
45242
US

V. Phone/Fax

Practice location:
  • Phone: 937-641-3000
  • Fax:
Mailing address:
  • Phone: 513-515-6619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86169615
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: