Individual
MARY BRAISTED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN CDN
Contact information
Practice address
675 MAIN ST, MIDDLETOWN, CT 06457-2732
(860) 347-6971
Mailing address
180 RANDOLPH RD, MIDDLETOWN, CT 06457-5605
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
03/07/2022
Last updated
03/07/2022
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