Provider Demographics
NPI:1699291906
Name:SCHAUB, DANA (MS RD LD)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:SCHAUB
Suffix:
Gender:F
Credentials:MS RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2316 BROADMOOR DR
Mailing Address - Street 2:
Mailing Address - City:GAUTIER
Mailing Address - State:MS
Mailing Address - Zip Code:39553-2615
Mailing Address - Country:US
Mailing Address - Phone:251-472-6518
Mailing Address - Fax:
Practice Address - Street 1:2316 BROADMOOR DR
Practice Address - Street 2:
Practice Address - City:GAUTIER
Practice Address - State:MS
Practice Address - Zip Code:39553-2615
Practice Address - Country:US
Practice Address - Phone:251-472-6518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
982713133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered