Provider Demographics
NPI:1922325117
Name:BEHANNA, ANGELA (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:BEHANNA
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 BELLEAUWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:TRAFFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15085-1220
Mailing Address - Country:US
Mailing Address - Phone:412-855-9286
Mailing Address - Fax:
Practice Address - Street 1:107 BELLEAUWOOD BLVD
Practice Address - Street 2:
Practice Address - City:TRAFFORD
Practice Address - State:PA
Practice Address - Zip Code:15085-1220
Practice Address - Country:US
Practice Address - Phone:412-855-9286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-27
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004247133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered