Provider Demographics
NPI:1376275164
Name:RICHARDS, BAILEY ELIZABETH (MS, RD, LD)
Entity Type:Individual
Prefix:MS
First Name:BAILEY
Middle Name:ELIZABETH
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3849 COLLINE DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-3357
Mailing Address - Country:US
Mailing Address - Phone:334-322-2309
Mailing Address - Fax:
Practice Address - Street 1:3849 COLLINE DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-3357
Practice Address - Country:US
Practice Address - Phone:334-322-2309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3384133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered