Provider Demographics
NPI:1144303959
Name:HABERFIELD, ANGELA R (RD, LD, CDE)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:R
Last Name:HABERFIELD
Suffix:
Gender:F
Credentials:RD, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 DENNIS LN
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-1607
Mailing Address - Country:US
Mailing Address - Phone:740-359-1825
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL PARK
Practice Address - Street 2:WHEELING HOSPITAL
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6379
Practice Address - Country:US
Practice Address - Phone:304-242-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2082-0495174400000X
WV624133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV624OtherWV BOARD OF LICENSED DIETITIANS
952452OtherCOMMISSION ON DIETETIC REGISTRATION
2082-0495OtherNATIONAL CERTIFICATION BOARD FOR DIABETES EDUCATORS