NPI 1639335623

Deana S Boucher, RD

Practitioner Registered Dietitian Middlebury, CT

Practice location

Address: 590 Middlebury Rd, Middlebury, CT 06762-2562
Phone: (203) 758-1004
Fax: (203) 758-1551
Mailing address: 1625 Straits Tpke, Middlebury, CT 06762-1836

Registered specialties

Registered Dietitian Primary

Dietary & Nutritional Service Providers Taxonomy 133V00000X Licence 000847 (CT)

Other Dietitian, Registered providers in Connecticut →

Registry record

NPI: 1639335623
Entity type: Individual
Sex (as registered): Female
NPI issued: 30 Jul 2008
Record last updated: 30 Jul 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.