Individual
CELINA RAQUEL FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, LD
Contact information
Practice address
3724 JEFFERSON ST STE 104, AUSTIN, TX 78731-6204
(330) 550-1120
Mailing address
3031 9TH ST, CUYAHOGA FALLS, OH 44221-1627
(330) 550-1120
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
08955
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08955
LICENSED DIETITIAN
OH
01
—
14146
LICENSED DIETITIAN
FL
01
—
158073
LICENSED DIETITIAN- STATE OF MONTANA
MT
01
—
86117372
REGISTERED DIETITIAN
—
Enumeration date
11/15/2019
Last updated
04/15/2025
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