Individual
SUSAN DELAGRANGE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RDCD
Contact information
Practice address
7916 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 432-2297
(260) 436-4380
Mailing address
PO BOX 2505, FORT WAYNE, IN 46801-2505
(260) 432-2297
(260) 436-4380
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37001523
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000355286
ANTHEM
IN
Enumeration date
03/20/2006
Last updated
07/08/2007
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