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General NPI Number Information
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NPI Number | 1083870059
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Entity Type | Individual
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Provider Name | KATHERYN ROSE TALCOTT MS, RD, CDE, LD
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Gender | Female
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Dates
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Enumeration Date | 07/30/2008
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Last Update Date | 02/04/2022
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Provider Practice Location Address
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Address Line | 400 SUGAR CAMP CIR STE 205
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City | OAKWOOD
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State | OH
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Zip | 45409-1981
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Country | US
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Telephone | 937-395-3656
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Fax | 937-395-3657
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Provider Business Mailing Address
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Address Line | 3170 KETTERING BLVD BLDG B
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City | MORAINE
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State | OH
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Zip | 45439-1924
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Country | US
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Telephone | 937-991-3188
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Fax | 937-223-9811
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 4341
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License Number State | OH
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