Provider Demographics
NPI:1588993877
Name:VAN HELDEN, BETHANY WEAVER (MS, RD)
Entity type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:WEAVER
Last Name:VAN HELDEN
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2025 TRAVERWOOD DR
Mailing Address - Street 2:SUITE A2
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-2197
Mailing Address - Country:US
Mailing Address - Phone:734-998-2156
Mailing Address - Fax:734-998-2161
Practice Address - Street 1:2025 TRAVERWOOD DR
Practice Address - Street 2:SUITE A2
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-2197
Practice Address - Country:US
Practice Address - Phone:734-998-2156
Practice Address - Fax:734-998-2161
Is Sole Proprietor?:No
Enumeration Date:2009-12-15
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0925135133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered