Provider Demographics
NPI:1194168310
Name:SCHAEFER, ALIXS TAHIA (ND)
Entity type:Individual
Prefix:MRS
First Name:ALIXS
Middle Name:TAHIA
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9529 WORSWICK CT
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6423
Mailing Address - Country:US
Mailing Address - Phone:954-257-1274
Mailing Address - Fax:
Practice Address - Street 1:9529 WORSWICK CT
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6423
Practice Address - Country:US
Practice Address - Phone:954-257-1274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ001323133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education