Provider Demographics
NPI:1598094781
Name:BECHT, MARY BETH (RD)
Entity Type:Individual
Prefix:
First Name:MARY BETH
Middle Name:
Last Name:BECHT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 456
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-0456
Mailing Address - Country:US
Mailing Address - Phone:317-847-4225
Mailing Address - Fax:317-863-0324
Practice Address - Street 1:3155 JASON ST
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033-8765
Practice Address - Country:US
Practice Address - Phone:317-575-8805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN597642133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric