Provider Demographics
NPI:1538524707
Name:AGUDELO, CELIA (RD, LDN)
Entity type:Individual
Prefix:MRS
First Name:CELIA
Middle Name:
Last Name:AGUDELO
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 5TH AVE
Mailing Address - Street 2:A LEVEL CRAWFORD BUILDING
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15132-2422
Mailing Address - Country:US
Mailing Address - Phone:412-664-6736
Mailing Address - Fax:412-664-2284
Practice Address - Street 1:1500 5TH AVE
Practice Address - Street 2:A LEVEL CRAWFORD BUILDING
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-2422
Practice Address - Country:US
Practice Address - Phone:412-664-6736
Practice Address - Fax:412-664-2284
Is Sole Proprietor?:No
Enumeration Date:2015-12-15
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004542133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered