Provider Demographics
NPI:1548860075
Name:ALAUDHI, MONA (RD)
Entity type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:ALAUDHI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42073 CAMDEN RD
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48111-2346
Mailing Address - Country:US
Mailing Address - Phone:734-607-2298
Mailing Address - Fax:
Practice Address - Street 1:3280 WASHTENAW AVE STE B
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-4283
Practice Address - Country:US
Practice Address - Phone:734-369-8782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI944715133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered