Individual
BROOKE ANN MARIE DECELLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, CDN
Contact information
Practice address
200 MARKET STREET, STE 5 PMB 112, POTSDAM, NY 13676-1217
(315) 528-4711
Mailing address
200 MARKET STREET, STE 5 PMB 112, POTSDAM, NY 13676-1217
(315) 528-4711
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
010313-01
NY
133V00000X
Registered Dietitian
01031301
NY
133V00000X
Registered Dietitian
DN007980
PA
Other
Enumeration date
01/03/2021
Last updated
08/15/2024
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