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General NPI Number Information
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NPI Number | 1801334131
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Entity Type | Individual
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Provider Name | ALISON BIRKS LDN
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Gender | Female
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Dates
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Enumeration Date | 02/07/2017
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Last Update Date | 02/07/2017
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Provider Practice Location Address
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Address Line | 129 MAIN ST N
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City | WOODBURY
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State | CT
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Zip | 06798-2955
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Country | US
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Telephone | 203-263-0673
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 825
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City | WOODBURY
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State | CT
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Zip | 06798-0825
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Country | US
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Telephone | 860-733-5191
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 001179
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License Number State | CT
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