Individual
DEANA S BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
590 MIDDLEBURY RD, MIDDLEBURY, CT 06762-2562
(203) 758-1004
(203) 758-1551
Mailing address
1625 STRAITS TPKE, MIDDLEBURY, CT 06762-1836
(203) 572-9512
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
000847
CT
Other
Enumeration date
07/30/2008
Last updated
07/30/2008
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