Provider Demographics
NPI:1770150443
Name:MOONEY, ASHLEY CHRISTINE (MS RDN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:CHRISTINE
Last Name:MOONEY
Suffix:
Gender:F
Credentials:MS RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8826 MINNOW CREEK DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-5042
Mailing Address - Country:US
Mailing Address - Phone:850-755-7237
Mailing Address - Fax:
Practice Address - Street 1:8826 MINNOW CREEK DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32312-5042
Practice Address - Country:US
Practice Address - Phone:850-755-7237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND8693133N00000X
FL86114488133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist