Provider Demographics
NPI:1861976045
Name:MASHNI, KATIA HAWATMEH
Entity type:Individual
Prefix:
First Name:KATIA
Middle Name:HAWATMEH
Last Name:MASHNI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:671 AQUILA DR
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-8320
Mailing Address - Country:US
Mailing Address - Phone:347-927-2478
Mailing Address - Fax:
Practice Address - Street 1:2121 ABBOT RD
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-8535
Practice Address - Country:US
Practice Address - Phone:734-927-2478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-24
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty