Provider Demographics
NPI:1811249022
Name:SEVERA, HOPE ASHLEY (RD, LD)
Entity type:Individual
Prefix:MRS
First Name:HOPE
Middle Name:ASHLEY
Last Name:SEVERA
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 1:150 CROSS ST
Mailing Address - Street 2:COMMUNITY SUPPORT SERVICES INC
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44311
Mailing Address - Country:US
Mailing Address - Phone:330-253-9388
Mailing Address - Fax:330-253-0377
Practice Address - Street 1:150 CROSS ST
Practice Address - Street 2:COMMUNITY SUPPORT SERVICES INC
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311
Practice Address - Country:US
Practice Address - Phone:330-253-9388
Practice Address - Fax:330-253-0377
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.6997133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHLD.6997OtherREGISTERED DIETICIAN