Individual
MS. MARY KATHRYN AUSICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CDE
Contact information
Practice address
7901 S 12TH ST STE 200, PORTAGE, MI 49024-3831
(269) 341-8585
Mailing address
601 JOHN STREET, BOX 39, KALAMAZOO, MI 49007
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1024516
—
Other
Enumeration date
09/29/2017
Last updated
07/16/2020
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