Provider Demographics
NPI:1104114982
Name:CYKIERT, DENISE (RD)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:
Last Name:CYKIERT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39830 GRAND RIVER AVE
Mailing Address - Street 2:B3
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-2140
Mailing Address - Country:US
Mailing Address - Phone:248-477-6100
Mailing Address - Fax:
Practice Address - Street 1:39830 GRAND RIVER AVE
Practice Address - Street 2:B3
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-2140
Practice Address - Country:US
Practice Address - Phone:248-477-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1017001133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered