Individual
KATHLEEN R VANHAVERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, RD, CDE, CDN
Contact information
Practice address
25 GERMANTOWN RD, DANBURY, CT 06810-5036
(203) 794-5637
(203) 794-5642
Mailing address
25 GERMANTOWN RD, DANBURY, CT 06810-5036
(203) 794-5637
(203) 794-5642
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
000850
CT
133V00000X
Registered Dietitian
003627
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
133884168
BEECH STREET
NY
Enumeration date
02/16/2006
Last updated
11/08/2010
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