Individual
BRENDA BAILLARGEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., L.D.N.
Contact information
Practice address
31 HASTINGS ST, MENDON, MA 01756-1090
(508) 883-7322
Mailing address
PO BOX 506, 31 HASTINGS ST., MENDON, MA 01756-0506
(508) 883-7322
(508) 883-7322
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
378
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT0225
MEDICARE, PTAN
MA
Enumeration date
01/09/2009
Last updated
01/09/2009
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