Provider Demographics
NPI:1962394064
Name:BEHN, CARRIE (RD, CSG)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:BEHN
Suffix:
Gender:F
Credentials:RD, CSG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 S 250 E
Mailing Address - Street 2:
Mailing Address - City:IVINS
Mailing Address - State:UT
Mailing Address - Zip Code:84738-5059
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:515 S 250 E
Practice Address - Street 2:
Practice Address - City:IVINS
Practice Address - State:UT
Practice Address - Zip Code:84738-5059
Practice Address - Country:US
Practice Address - Phone:714-502-4012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10825328-4901133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC3167OtherDIETITIAN LICENSE
ORLD-D-10242268OtherOREGON HEALTH LICENSING - BOARD OF LICENSED DIETITIANS
WADI61543401OtherWASHINGTON STATE DIETITIAN CERTIFICATION
UT10825328-4901OtherUTAH DOPL DIETITIAN CERTIFICATION
86079203OtherCOMMISSION ON DIETETIC REGISTRATION