Provider Demographics
NPI:1588447783
Name:SCHULTE, CARLA ROBERTA (RD)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:ROBERTA
Last Name:SCHULTE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:CARLA
Other - Middle Name:ROBERTA
Other - Last Name:KNAPP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2309 PARK AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45212-3364
Mailing Address - Country:US
Mailing Address - Phone:937-424-7511
Mailing Address - Fax:
Practice Address - Street 1:2309 PARK AVE APT 3
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:OH
Practice Address - Zip Code:45212-3364
Practice Address - Country:US
Practice Address - Phone:937-424-7511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.10031133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty