Healthcare Provider Details

I. General information

NPI: 1336272145
Provider Name (Legal Business Name): MARION JUDITH CAMP R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 08/23/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 WESTFIELD ST
WEST SPRINGFIELD MA
01089-2577
US

IV. Provider business mailing address

36 CANAL DR
WESTFIELD MA
01085-5031
US

V. Phone/Fax

Practice location:
  • Phone: 413-786-2957
  • Fax:
Mailing address:
  • Phone: 508-572-5077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2366
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: