# DIVERGENT DIETITIAN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083463749
- **Authorized official:** BETHANY ANNE DARIO MPH, RDN, LD (OWNER)
- **Authorized official phone:** (419) 410-3541

## Contact information

- **Practice address:** 308 LOUISIANA AVE, PERRYSBURG, OH 43551-1461
- **Practice address phone:** (567) 801-0792
- **Mailing address:** 308 LOUISIANA AVE, PERRYSBURG, OH 43551-1461
- **Mailing address phone:** (419) 410-3541

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/15/2024
- **Last updated:** 09/11/2025