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Individual

MS. KAREN M. CLEVELAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD, CD

Contact information

Practice address
600 EAST BLVD, NUTRITION SERVICES DEPARTMENT, ELKHART, IN 46514-2483
(574) 523-3236
(574) 296-6504
Mailing address
PO BOX 4776, SOUTH BEND, IN 46634-4667
(574) 523-3148
(574) 523-3492

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
720478
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
37000844A
CERTIFICATION NUMBER
IN
01
720478
LICENSE
IN
Enumeration date
12/05/2006
Last updated
04/10/2009
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