Deana S Boucher RD

NPI 1639335623 - Dietitian, Registered - 133V00000X

NPI Details
NPI 1639335623
Gender Female
Enumeration Date 07/30/2008
Last Updated 07/30/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
590 MIDDLEBURY RD
MIDDLEBURY CT, 06762-2562, US
Phone (203) 758-1004
Fax (203) 758-1551
Business Location
1625 STRAITS TPKE
MIDDLEBURY CT, 06762-1836, US
Phone (203) 572-9512
Fax
Toxanomy
Taxonomy Code 133V00000X
License State Connecticut
License Number 000847
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According to our database, Deana S Boucher RD NPI is 1639335623, taxonomy code is 133V00000X and license number is 000847, license state is located at Connecticut. Deana S Boucher RD physically located at 590 Middlebury Rd, Middlebury CT, 06762-2562. NPI Number Deana S Boucher RD has the Individual type.

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1639335623 NPI number is provided on an as is basis without warranty of any kind. 1639335623 is maintained by the National Plan & Provider Enumeration System. The contents of Deana S Boucher RD are for informational purposes only.