Provider Demographics
NPI:1194495630
Name:AL SHAIKH YASIN, WALA (MS, RD)
Entity type:Individual
Prefix:MRS
First Name:WALA
Middle Name:
Last Name:AL SHAIKH YASIN
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 HOWARD AVE., UNIT 3
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:N9A1S2
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:870 HOWARD AVE., UNIT #3
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:ON
Practice Address - Zip Code:N9A 1S2
Practice Address - Country:CA
Practice Address - Phone:226-678-9498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133VN1101X, 133VN1301X, 133VN1201X
NY86118115133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1101XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Gerontological
No133VN1301XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Oncology
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management