Individual
ILENE B SIEGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
130 FISHER RD, BERLIN, VT 05602-9516
(802) 371-4152
(802) 371-4572
Mailing address
PO BOX 547, ATT: CVMC FINANCE DEPT, BARRE, VT 05641-0547
(802) 371-4152
(802) 371-4572
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
074-0000033
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022299
—
VT
01
—
28599
BCBS PROVIDER NUMBER
VT
Enumeration date
04/02/2007
Last updated
10/24/2013
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