Basic Information
| Provider Information | |||||||||
| NPI: | 1992717680 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AUCH | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | ANGELYN | ||||||||
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| Credential: | RDLN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5074 | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571175074 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053286585 | ||||||||
| FaxNumber: | 6053286512 | ||||||||
| Practice Location | |||||||||
| Address1: | 20 S PLUM ST | ||||||||
| Address2: | |||||||||
| City: | VERMILLION | ||||||||
| State: | SD | ||||||||
| PostalCode: | 570693346 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6056242611 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 0067 | SD | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.