Healthcare Provider Details

I. General information

NPI: 1063219574
Provider Name (Legal Business Name): MELISSA MORNINGSTAR VAJAS RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA LYNN MORNINGSTAR RD

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10251 BELLEAU DR
TWINSBURG OH
44087-1152
US

IV. Provider business mailing address

10251 BELLEAU DR
TWINSBURG OH
44087-1152
US

V. Phone/Fax

Practice location:
  • Phone: 440-387-3508
  • Fax:
Mailing address:
  • Phone: 440-387-3508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number7285
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: