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General NPI Number Information
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NPI Number | 1710870555
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Entity Type | Organization
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Legal Business Name | DIERDRE BEARD
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 100 WEST RD STE 300
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City | TOWSON
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State | MD
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Zip | 21204-2370
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Country | US
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Telephone | 423-202-5685
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Fax |
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Provider Business Mailing Address
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Address Line | 851 FRENCH MOORE JR BLVD # 20
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City | ABINGDON
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State | VA
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Zip | 24210-4738
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Country | US
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Telephone | 423-202-5685
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Fax |
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Authorized Official
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Title or Position | LICENSED DIETIAN NUTRITIONIST
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Name | DIERDRE BEARD
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Credential | LDN
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Telephone | 423-202-5685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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