Healthcare Provider Details

I. General information

NPI: 1386558518
Provider Name (Legal Business Name): SHELBY LYNNE LEE RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 ROAD 103
PAULDING OH
45879-8776
US

IV. Provider business mailing address

13131 ROAD 13
OTTAWA OH
45875-9531
US

V. Phone/Fax

Practice location:
  • Phone: 419-796-0153
  • Fax:
Mailing address:
  • Phone: 419-796-0153
  • Fax: 614-808-3854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: