Individual
STACEY LEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CDN, CNSC
Contact information
Practice address
130 DIVISION ST, DERBY, CT 06418-1326
(203) 732-7585
Mailing address
88 WASHINGTON AVE, SEYMOUR, CT 06483-3127
(203) 231-5544
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
000933
CT
Other
Enumeration date
07/31/2014
Last updated
08/01/2014
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