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General NPI Number Information
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NPI Number | 1528979713
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Entity Type | Individual
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Provider Name | IVY MENDHEIM RD, LDN
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Gender | Female
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Dates
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Enumeration Date | 09/15/2026
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Last Update Date | 09/15/2026
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Provider Practice Location Address
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Address Line | 190 GREENBRIER BLVD STE 105
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City | COVINGTON
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State | LA
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Zip | 70433-7237
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Country | US
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Telephone | 985-789-3341
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Fax |
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Provider Business Mailing Address
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Address Line | 73561 HIGHWAY 437
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City | COVINGTON
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State | LA
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Zip | 70435-6159
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Country | US
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Telephone | 985-789-3341
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 4284
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License Number State | LA
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