Individual
JESSICA LAUREN THONGPARN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
204 NEW HAVEN AVE UNIT 8C, DERBY, CT 06418-2150
(860) 806-5013
Mailing address
204 NEW HAVEN AVE UNIT 8C, DERBY, CT 06418-2150
(860) 806-5013
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
957503
CT
Other
Enumeration date
01/19/2021
Last updated
01/19/2021
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