-- MIREILLE BLACKE -- MA, RD, CD-N
Individual Provider (NPI-1)
Active
Dietitian, Registered
Provider Information
- NPI Number
1861768889- Provider Type
- Individual Provider (NPI-1)
- Credentials
- MA, RD, CD-N
- Status
- Active
Contact & Location
- Address
- 6122 TOWN RDG, MIDDLETOWN, CT, 064576551
- Phone
- (203) 233-6680
- Fax
- (860) 852-3465
Specialties & Taxonomies
Nutritionist, Nutrition, Education
License: CT #001082
Dietitian, Registered
Primary License: CT #1073878