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Individual
AMANDA BREWSAUGH
Active
Individual
AMANDA BREWSAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
001134
CT
133V00000X
Registered Dietitian
Primary
LD.7583
OH
133VN1004X
Pediatric Nutrition Registered Dietitian
1069423
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001134
STATE CERTIFICATION
CT
01
—
C02658
YALE NEW HAVEN HOSPITAL MEDICARE NUMBER
CT
Enumeration date
07/02/2013
Last updated
01/23/2020
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