Organization
DIETITIANCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH M FITZHUGH RDN (OWNER)
(219) 309-1577
Entity
Organization
Contact information
Practice address
1775 S BASSWOOD TRL, LA PORTE, IN 46350-9289
(219) 309-1577
Mailing address
PO BOX 2621, CHESTERTON, IN 46304
(219) 309-1577
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
1640045A
IL
133V00000X
Registered Dietitian
Primary
37000345A
IN
133VN1006X
Metabolic Nutrition Registered Dietitian
79000014A
—
174H00000X
Health Educator
—
—
Other
Enumeration date
05/17/2017
Last updated
05/17/2017
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