Individual
S ELISE BRATCHER CUSHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
3522 RT 113, THETFORD, VT 05074
(802) 333-9003
Mailing address
PO BOX 52, THETFORD, VT 05074-0052
(802) 333-9003
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
074.0134366
VT
133VN1301X
Oncology Nutrition Registered Dietitian
0613
NH
Other
Enumeration date
04/10/2024
Last updated
04/10/2024
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