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Individual

ANGELA VICTORIA SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, RD, CSN, LDN

Contact information

Practice address
281 COBBLER LN, SOUTHBURY, CT 06488-2686
(203) 456-5284
Mailing address
281 COBBLER LN, SOUTHBURY, CT 06488-2686
(203) 456-5284

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
59.002949
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
59.002949
STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH
CT
01
86378409
COMMISSION ON DIETETIC REGISTRATION
Enumeration date
08/04/2025
Last updated
08/22/2025
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