Doctor Name: | MRS. MARYSE BEAUDOUIN DEROSENA |
NPI Number: | 1285740324 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BS MHA LDN |
License Number: | |
Business Practice Address: | 2405 Essington Rd Suite # 80 Joliet, IL - 604351200 |
Business Phone Number: | 8152366441 |
Business Fax Number: | 6302932937 |
Mailing Address: | 2405 Essington Rd, Suite # 80 JOLIET |
State: | IL |
Postal Code: | 604351200 |
Phone Number: | 8152366441 |
Fax Number: | 6302932937 |
NPI Enumeration Date: | 08/22/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |