NPI 1225629066 · live from the CMS NPI Registry
Samantha Rose Beaman, RDN
Dietitian, Registered in Livonia, MI. National Provider Identifier 1225629066, active.
NPI record
| NPI | 1225629066 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 32185 Camborne Ln, Livonia, MI 48154 |
| Practice phone | 313-618-9718 |
| Enumerated | February 2, 2021 |
| Last updated | February 2, 2021 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 86115912 (MI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.