Individual
DIANA MARIE BRUEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2304 BOULDER RUN CT, HENRICO, VA 23238-3644
(510) 227-0999
Mailing address
2304 BOULDER RUN CT, HENRICO, VA 23238-3644
(510) 227-0999
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
979829
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
979829
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
06/21/2019
Last updated
06/21/2019
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