Doctor Name: | AMANDA BETH BOHON |
NPI Number: | 1760755367 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., R.D., L.D. |
License Number: | 1285 |
Business Practice Address: | 1600 W 40th Ave Nutritional Services Pine Bluff, AR - 716036301 |
Business Phone Number: | 8705414723 |
Business Fax Number: | 8705417933 |
Mailing Address: | 601 Napa Valley Dr Apt 1035, LITTLE ROCK |
State: | AR |
Postal Code: | 722112358 |
Phone Number: | 5807618210 |
Fax Number: | 8705417933 |
NPI Enumeration Date: | 02/14/2012 |
NPI Last Update Date: | 02/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 1285 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
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 |