| Doctor Name: | MARTHA LEAH MAGLIOLA |
| NPI Number: | 1164647004 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.D.,C.D. |
| License Number: | 37000920A |
| Business Practice Address: | 615 N Michigan St South Bend, IN - 466011033 |
| Business Phone Number: | 5746477335 |
| Business Fax Number: | |
| Mailing Address: | 14650 Tranquil Ct, GRANGER |
| State: | IN |
| Postal Code: | 465308301 |
| Phone Number: | 5742775378 |
| Fax Number: | |
| NPI Enumeration Date: | 04/16/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | 37000920A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |