Provider Demographics
NPI:1710911607
Name:WILLIAMS, BETH JANE (MS, RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:JANE
Last Name:WILLIAMS
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 1:322A ELM ST
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-3009
Mailing Address - Country:US
Mailing Address - Phone:207-284-4586
Mailing Address - Fax:207-286-3273
Practice Address - Street 1:322A ELM ST
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-3009
Practice Address - Country:US
Practice Address - Phone:207-284-4586
Practice Address - Fax:207-286-3273
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MED1791133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered