Individual
BONNIE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, RYT-200
Contact information
Practice address
17418 COUNTRY CLUB DR, LIVONIA, MI 48152-4802
(734) 419-3549
Mailing address
PO BOX 532071, LIVONIA, MI 48153-2071
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
06/07/2020
Last updated
03/08/2021
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