Provider Demographics
NPI:1669224630
Name:HINEY, KAYLA (RD LD)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:HINEY
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 1:5508 NORTON CT
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-1656
Mailing Address - Country:US
Mailing Address - Phone:304-552-0637
Mailing Address - Fax:
Practice Address - Street 1:5508 NORTON CT
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-1656
Practice Address - Country:US
Practice Address - Phone:304-552-0637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6919133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered