NPI 1669860409

Jody Wagner

Practitioner Registered Dietitian Derby, CT

Practice location

Address: 130 Division St, Derby, CT 06418-1326
Phone: (860) 478-8695

Registered specialties

Registered Dietitian Primary

Dietary & Nutritional Service Providers Taxonomy 133V00000X Licence 001295 (CT)

Other Dietitian, Registered providers in Connecticut →

Registry record

NPI: 1669860409
Entity type: Individual
Sex (as registered): Female
NPI issued: 1 Jan 2015
Record last updated: 1 Jan 2015

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.