Individual
SANDY RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CDN
Contact information
Practice address
1180 NEWFIELD AVE, STAMFORD, CT 06905-1409
(314) 888-5233
(203) 590-8644
Mailing address
1180 NEWFIELD AVE, STAMFORD, CT 06905-1409
(314) 888-5233
(203) 590-8644
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
002211
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002211
CERTIFIED DIETITIAN/NUTRITIONIST
CT
Enumeration date
07/15/2022
Last updated
06/08/2023
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