Organization
DIVERGENT DIETITIAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETHANY ANNE DARIO MPH, RDN, LD (OWNER)
(419) 410-3541
Entity
Organization
Contact information
Practice address
308 LOUISIANA AVE, PERRYSBURG, OH 43551-1461
(567) 801-0792
Mailing address
308 LOUISIANA AVE, PERRYSBURG, OH 43551-1461
(419) 410-3541
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
05/15/2024
Last updated
09/11/2025
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