Provider Demographics
NPI:1982383857
Name:LOONEY, BETH (RDN)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:LOONEY
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 LONDON WAY
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-6800
Mailing Address - Country:US
Mailing Address - Phone:904-460-3130
Mailing Address - Fax:
Practice Address - Street 1:121 LONDON WAY
Practice Address - Street 2:
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-6800
Practice Address - Country:US
Practice Address - Phone:904-460-3130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND7088133V00000X
GALD006482133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered