Provider Demographics
NPI:1053355495
Name:TURNER, CATHLEEN RAE (RD, LD)
Entity type:Individual
Prefix:MRS
First Name:CATHLEEN
Middle Name:RAE
Last Name:TURNER
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 E STATE ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-4957
Mailing Address - Country:US
Mailing Address - Phone:330-821-1657
Mailing Address - Fax:330-821-1735
Practice Address - Street 1:4689 FULTON DR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2379
Practice Address - Country:US
Practice Address - Phone:330-649-9400
Practice Address - Fax:330-649-8059
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3047133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHMT02051Medicare ID - Type UnspecifiedMEDICAL NUTRITION THERAPY