Provider Demographics
NPI:1588319073
Name:FORD, BETSY (MPH, RD, LDN)
Entity type:Individual
Prefix:
First Name:BETSY
Middle Name:
Last Name:FORD
Suffix:
Gender:F
Credentials:MPH, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11418 ROCKVILLE PIKE APT 805
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-6002
Mailing Address - Country:US
Mailing Address - Phone:252-292-2480
Mailing Address - Fax:
Practice Address - Street 1:11418 ROCKVILLE PIKE APT 805
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-6002
Practice Address - Country:US
Practice Address - Phone:252-292-2480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty