Individual
LAURIE B BEEBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
2100 MADISON AVE, GRANITE CITY, IL 62040-4701
(618) 798-3492
(618) 798-3871
Mailing address
2100 MADISON AVE, GRANITE CITY, IL 62040-4701
(618) 798-3492
(618) 798-3871
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
164003260
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164003260
ILLINOIS LICENSE #
IL
Enumeration date
04/24/2007
Last updated
07/08/2007
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