Doctor Name: | MRS. CAROLYN SUZANNE JOHANSEN |
NPI Number: | 1578607099 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD, CDE, CD |
License Number: | 074-0000070 |
Business Practice Address: | 20 S Main St Barre, VT - 056414826 |
Business Phone Number: | 8024767607 |
Business Fax Number: | 8022444122 |
Mailing Address: | 19 Windridge Ln, WATERBURY |
State: | VT |
Postal Code: | 056769135 |
Phone Number: | 8022444122 |
Fax Number: | 8022444122 |
NPI Enumeration Date: | 02/17/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 074-0000070 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |