Provider Demographics
NPI:1942798186
Name:AUGUSTE, BETH (RDN)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:AUGUSTE
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:MORSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:1901 S. 9TH STREET
Mailing Address - Street 2:BOK BUILDING, SUITE 508
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148
Mailing Address - Country:US
Mailing Address - Phone:267-281-3363
Mailing Address - Fax:
Practice Address - Street 1:1901 SOUTH 9TH STREET
Practice Address - Street 2:BOK BUILDING, #508
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148
Practice Address - Country:US
Practice Address - Phone:267-281-3363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-24
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1046348133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered