Provider Demographics
NPI:1427699883
Name:SCHENKENBERGER, ERIN (RD, LD)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:SCHENKENBERGER
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 TAKACS DR
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-1319
Mailing Address - Country:US
Mailing Address - Phone:330-354-9844
Mailing Address - Fax:
Practice Address - Street 1:200 INNOVATION WAY
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44316
Practice Address - Country:US
Practice Address - Phone:330-796-8877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5208133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered