Provider Demographics
NPI:1730706466
Name:VICHILL, ABIGAIL LOUISE (RDN)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:LOUISE
Last Name:VICHILL
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:
Other - Last Name:VICHILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:27349 MAURER DR
Mailing Address - Street 2:
Mailing Address - City:OLMSTED TWP
Mailing Address - State:OH
Mailing Address - Zip Code:44138-1782
Mailing Address - Country:US
Mailing Address - Phone:440-799-5355
Mailing Address - Fax:
Practice Address - Street 1:19970 INGERSOLL DR
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-1820
Practice Address - Country:US
Practice Address - Phone:440-799-5355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-29
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.08932133VN1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports Dietetics