Individual
LUCINDA MARIA BALSOME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.,R.D.
Contact information
Practice address
62 KELSEY LN, GLASTONBURY, CT 06033-5015
(860) 796-4160
Mailing address
62 KELSEY LN, GLASTONBURY, CT 06033-5015
(860) 796-4160
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
000080
CT
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
720769
IL
Other
Enumeration date
06/07/2010
Last updated
06/07/2010
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