Individual
MELISSA EBDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
267 GRANT ST, BRIDGEPORT, CT 06610-2805
(203) 384-3075
Mailing address
267 GRANT ST, BRIDGEPORT, CT 06610-2805
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1066909
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1066909
COMMISION OF DIETETIC REGISTRATION
CT
Enumeration date
03/25/2020
Last updated
03/25/2020
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