Individual
BONNIE WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3314 BARRINGTON RD, BLOOMINGTON, IL 61704-8361
(801) 703-3303
Mailing address
3314 BARRINGTON RD, BLOOMINGTON, IL 61704-8361
(801) 703-3303
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1028102
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
03/29/2021
Last updated
03/29/2021
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