MEDICARE: RONELLE L MITCHELL R.D., CNSC

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
1	133V00000X	Registered Dietitian	LD.6931	OH

General Provider Information

NPI Number	:	1932472750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONELLE L MITCHELL R.D., CNSC

Provider Business Mailing Address
First Line	:	9378 S MASON MONTGOMERY RD # 322
Second Line	:
City	:	MASON
State	:	OH
Zip	:	45040-8827
Country	:	US
Telephone Number	:	907-230-7537
Fax Number	:

Provider Business Practice Location Address
First Line	:	7167 E KEMPER RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45249-1028
Country	:	US
Telephone Number	:	513-810-6824
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2012
Last Update Date	:	01/13/2022

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