Healthcare Provider Details

I. General information

NPI: 1902852122
Provider Name (Legal Business Name): RENEE MARIE WOLFORD R.D., L.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 BELLEFONTAINE AVE. OFFICE OF FOOD AND NUTRITION SERVICES
LIMA OH
45804-2800
US

IV. Provider business mailing address

1001 BELLEFONTAINE AVE
LIMA OH
45804-2800
US

V. Phone/Fax

Practice location:
  • Phone: 419-226-5091
  • Fax:
Mailing address:
  • Phone: 419-226-5091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD5327
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: