Organization
DESIRAE NICOLE NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESIRAE BEDGOOD RDN, LDN (REGISTERED DIETITIAN)
(318) 200-0491
Entity
Organization
Contact information
Practice address
1500 N 19TH ST, MONROE, LA 71201-4942
(318) 200-0491
Mailing address
1500 N 19TH ST, MONROE, LA 71201-4942
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
03/31/2022
Last updated
03/31/2022
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