Provider Demographics
NPI:1538825005
Name:BERGER, HALLIE (MS, RDN, LDN)
Entity type:Individual
Prefix:MRS
First Name:HALLIE
Middle Name:
Last Name:BERGER
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 N HAWTHORNE RD
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-1475
Mailing Address - Country:US
Mailing Address - Phone:484-680-8124
Mailing Address - Fax:
Practice Address - Street 1:38 N HAWTHORNE RD
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-1475
Practice Address - Country:US
Practice Address - Phone:484-680-8124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA86041445133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered