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General NPI Number Information
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NPI Number | 1043171457
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Entity Type | Individual
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Provider Name | KYM MARIE BRENNEMAN RD
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Gender | Female
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 23700 COMMERCE PARK
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City | BEACHWOOD
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State | OH
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Zip | 44122-5827
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Country | US
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Telephone | 216-292-5706
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Fax |
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Provider Business Mailing Address
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Address Line | 1461 MARYGUARD DR
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City | AKRON
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State | OH
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Zip | 44312-3844
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Country | US
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Telephone | 216-219-1649
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Fax | 216-219-1649
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 940711
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License Number State | OH
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