Individual
MICHELLE R IRVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD CDE
Contact information
Practice address
7 HIGATE LN, SIMSBURY, CT 06070-1005
(402) 612-4097
Mailing address
7 HIGATE LN, SIMSBURY, CT 06070-1005
(402) 612-4097
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
001790
IA
Other
Enumeration date
12/19/2007
Last updated
03/31/2021
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