Provider Demographics
NPI:1326874702
Name:HEINRICH, ASHLEY (MS, RDN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:HEINRICH
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5964 CHICAGO DR
Mailing Address - Street 2:
Mailing Address - City:ZEELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49464-9668
Mailing Address - Country:US
Mailing Address - Phone:616-283-3151
Mailing Address - Fax:
Practice Address - Street 1:5964 CHICAGO DR
Practice Address - Street 2:
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-9668
Practice Address - Country:US
Practice Address - Phone:616-283-3151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI86080305133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered