Individual
BETH ANN MONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD CD
Contact information
Practice address
751 TATEAM DR, DANVILLE, IN 46122-9384
(317) 745-5891
(765) 779-4010
Mailing address
751 TATEAM DR, DANVILLE, IN 46122-9384
(317) 745-5891
(765) 779-4010
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37001813A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200881730
FIRST STEPS LPI
IN
01
—
37001813A
INDIANA RD CERTIFICATION
IN
Enumeration date
04/28/2008
Last updated
04/28/2008
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