Provider Demographics
NPI:1811678329
Name:SAY, BETHANY (RD, LDN, CDCES)
Entity type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:
Last Name:SAY
Suffix:
Gender:F
Credentials:RD, LDN, CDCES
Other - Prefix:MISS
Other - First Name:BETHANY
Other - Middle Name:
Other - Last Name:MARKIEWICZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LDN, CDCES
Mailing Address - Street 1:18201 CONNEAUT LAKE RD
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-3757
Mailing Address - Country:US
Mailing Address - Phone:814-333-5064
Mailing Address - Fax:814-333-5067
Practice Address - Street 1:18201 CONNEAUT LAKE RD
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-3757
Practice Address - Country:US
Practice Address - Phone:814-333-5064
Practice Address - Fax:814-333-5067
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN006069133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered