Individual
MRS. KATHLEEN MARIE MONROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD CDN
Contact information
Practice address
100 PARK ST, GLENS FALLS, NY 12801-4413
(518) 926-2630
Mailing address
22 RED HOUSE LN, LAKE GEORGE, NY 12845-4608
(518) 747-6428
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
002208-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002208-1
DIETETICS
NY
Enumeration date
03/27/2007
Last updated
07/08/2007
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