Individual
DR. MAUREEN R LATANICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, RD, CDE
Contact information
Practice address
37 E WILSON BRIDGE RD, SUITE 270, WORTHINGTON, OH 43085-2354
(614) 396-6730
(614) 396-6734
Mailing address
374 WILBER AVE, COLUMBUS, OH 43215-1314
(614) 725-3248
(614) 396-6734
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1235
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000113720
OHIO BLUE SHIELD
OH
01
—
4398510
AETNA
OH
01
—
63-00016
UNITED HEALTHCARE
OH
Enumeration date
12/08/2006
Last updated
10/05/2012
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