Provider Demographics
NPI:1124876263
Name:CEMAL, AITEN (MS IN NUTRITIONAL SC)
Entity type:Individual
Prefix:
First Name:AITEN
Middle Name:
Last Name:CEMAL
Suffix:
Gender:F
Credentials:MS IN NUTRITIONAL SC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25118 SUNDANCE PARK LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-7338
Mailing Address - Country:US
Mailing Address - Phone:617-717-4224
Mailing Address - Fax:
Practice Address - Street 1:25118 SUNDANCE PARK LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-7338
Practice Address - Country:US
Practice Address - Phone:617-717-4224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-13
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X, 133NN1002X
A-3623635171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education