Individual
MRS. LORRAINE DAWN REARDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD CDN
Contact information
Practice address
21 GRAND STREET, HARTFORD, CT 06106
(860) 550-7500
(860) 550-7501
Mailing address
21 GRAND STREET, HARTFORD, CT 06106
(860) 550-7500
(860) 550-7501
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000557
DIETITIAN NUTRITIONIST
CT
05
—
004236007
—
CT
Enumeration date
01/10/2006
Last updated
11/26/2012
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