Individual
MS. GWENDOLYN MARIE EAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
11 WEST ST, NORTH BENNINGTON, VT 05257-9405
(518) 593-3318
Mailing address
11 WEST ST, NORTH BENNINGTON, VT 05257-9405
(518) 593-3318
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86168971
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10151996
—
VT
Enumeration date
11/16/2022
Last updated
11/16/2022
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