Doctor Name: | EMILY CICERO |
NPI Number: | 1174982839 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD |
License Number: | 37002011A |
Business Practice Address: | 3909 New Vision Dr Fort Wayne, IN - 468451725 |
Business Phone Number: | 2604696602 |
Business Fax Number: | 2609693065 |
Mailing Address: | 1234 E Dupont Rd, FORT WAYNE |
State: | IN |
Postal Code: | 468251545 |
Phone Number: | 2604696602 |
Fax Number: | 2609693065 |
NPI Enumeration Date: | 02/23/2016 |
NPI Last Update Date: | 02/23/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 37002011A |
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 |