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NPI Code Detail

MEDICARE: MS. CINDY ANNE CASSELL PHD, RD, LD

MEDICARE: MS. CINDY ANNE CASSELL PHD, RD, LD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133VN1004XPediatric Nutrition Registered Dietitian4890OH
2133V00000XRegistered Dietitian4890OH
3133VN1006XMetabolic Nutrition Registered Dietitian4890OH
4133VN1006XMetabolic Nutrition Registered Dietitian
5133V00000XRegistered Dietitian
6133VN1004XPediatric Nutrition Registered Dietitian

General Provider Information

NPI Number : 1568772630
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CINDY ANNE CASSELL PHD, RD, LD
Provider Business Mailing Address
First Line : 2652 SR 132
Second Line :
City : NEW RICHMOND
State : OH
Zip : 45157-9019
Country : US
Telephone Number : 513-310-7963
Fax Number : 513-553-0293
Provider Business Practice Location Address
First Line : 2753 OBSERVATORY AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45208-2231
Country : US
Telephone Number : 513-310-7963
Fax Number : 513-553-0293
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2010
Last Update Date : 09/26/2011

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