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Individual
MALLORY H BAERENWALD
Active
Individual
MALLORY H BAERENWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,RD,CD
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3465-29
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86087767
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
11/05/2019
Last updated
04/18/2022
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