Individual
DIANE M ROUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
10-42 MITCHELL AVE, BINGHAMTON, NY 13903
(607) 763-6600
Mailing address
346 GRAND AVE, JOHNSON CITY, NY 13790
(607) 770-0025
(607) 729-3982
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
001233
NY
Other
Enumeration date
09/25/2006
Last updated
01/28/2010
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