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General NPI Number Information
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NPI Number | 1609403492
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Entity Type | Individual
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Provider Name | KAYLA RENEE ALUISE RD, CSO, LD
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Gender | Female
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Dates
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Enumeration Date | 03/24/2020
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 1044 BELMONT AVE
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City | YOUNGSTOWN
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State | OH
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Zip | 44504-1006
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Country | US
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Telephone | 330-480-8030
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Fax | 330-480-8049
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Provider Business Mailing Address
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Address Line | 13250 OLD HICKORY CT
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City | NORTH LIMA
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State | OH
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Zip | 44452-8527
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Country | US
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Telephone | 330-831-1806
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Fax | 330-480-8049
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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 | 133VN1301X
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Taxonomy Name | Oncology Nutrition Registered Dietitian
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License Number | LD.6910
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License Number State | OH
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