Individual
TAYLOR LYNN DEARTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
602 SOUTH ST, CHARDON, OH 44024-1499
(330) 559-4238
Mailing address
39116 PRINCETON CIR, AVON, OH 44011-1777
(330) 559-4238
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
8104
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02122244
—
OH
Enumeration date
07/08/2021
Last updated
07/08/2021
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