Individual
MRS. ALICIA BUTERBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD, CDE
Contact information
Practice address
2510 COMMONS BLVD STE 160, BEAVERCREEK, OH 45431-3834
(937) 401-7575
Mailing address
1 PRESTIGE PL STE 550, MIAMISBURG, OH 45342-6115
(937) 762-1310
(937) 522-8068
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0421279
—
OH
Enumeration date
08/26/2020
Last updated
04/06/2022
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