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General NPI Number Information
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NPI Number | 1942829320
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Entity Type | Individual
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Provider Name | CHELSEA CATHLEEN BEALE RD
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Gender | Female
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Dates
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Enumeration Date | 04/15/2020
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 427 E WASHINGTON ST
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City | SAINT LOUIS
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State | MI
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Zip | 48880-1980
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Country | US
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Telephone | 989-708-2867
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Fax |
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Provider Business Mailing Address
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Address Line | 1616 WOOD POINTE LN UNIT 1
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City | MIDLAND
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State | MI
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Zip | 48642-3380
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Country | US
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Telephone | 989-708-2867
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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 | 133VN1101X
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Taxonomy Name | Gerontological Nutrition Registered Dietitian
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License Number | 86089832
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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License Number | 86089832
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 86089832
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License Number State | MI
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