Desirae Nicole Nutrition LLC

NPI #1588304182 in Monroe, Louisiana

Provider Information

NPI Number: 1588304182
Entity Type: Organization
Organization Name: Desirae Nicole Nutrition LLC
Primary Specialty: Dietitian, Registered
Enumeration Date: Mar 31, 2022
Last Updated: Mar 31, 2022

Practice Location

Address: 1500 N 19TH ST
City: Monroe
State: Louisiana
ZIP Code: 71201-4942
Phone: (318) 200-0491

Authorized Official

Name: DESIRAE BEDGOOD, RDN, LDN
Title: REGISTERED DIETITIAN
Phone: (318) 200-0491

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dietitian, Registered	133V00000X	Primary

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