Provider Demographics
NPI:1538022660
Name:PIECUCH, JESSICA (RD,LD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:PIECUCH
Suffix:
Gender:F
Credentials:RD,LD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:FIORILLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD,LD
Mailing Address - Street 1:23700 COMMERCE PARK
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5827
Mailing Address - Country:US
Mailing Address - Phone:216-292-5706
Mailing Address - Fax:
Practice Address - Street 1:6831 N CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-3929
Practice Address - Country:US
Practice Address - Phone:330-297-4564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-05
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.09210133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered