Individual
ELIZABETH ANNE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2790 MAIN ST, GLASTONBURY, CT 06033-4607
(860) 430-9922
Mailing address
69 FOX RIDGE LN, HEBRON, CT 06248-1382
(860) 338-9133
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
18004653203
CT
133V00000X
Registered Dietitian
PENDING
CT
Other
Enumeration date
09/02/2021
Last updated
09/03/2021
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