Healthcare Provider Details

I. General information

NPI: 1821522046
Provider Name (Legal Business Name): SUZANNE HINCK RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2017
Last Update Date: 04/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30625 SOLON RD SUITE C
SOLON OH
44139-3472
US

IV. Provider business mailing address

3282 CLARENDON RD
CLEVELAND HEIGHTS OH
44118-4252
US

V. Phone/Fax

Practice location:
  • Phone: 216-378-0888
  • Fax:
Mailing address:
  • Phone: 612-812-6674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD.7674
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: