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General NPI Number Information
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NPI Number | 1902612690
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Entity Type | Organization
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Legal Business Name | DEBORAH PEPPER-DOUGHERTY, RD, LD
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Dates
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Enumeration Date | 12/06/2024
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 22 WILDWOOD BLVD
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City | CUMBERLAND FORESIDE
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State | ME
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Zip | 04110-1213
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Country | US
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Telephone | 207-318-7353
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Fax | 207-781-4925
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Provider Business Mailing Address
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Address Line | 22 WILDWOOD BLVD
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City | CUMBERLAND FORESIDE
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State | ME
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Zip | 04110-1213
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Country | US
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Telephone | 207-318-7353
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Fax |
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Authorized Official
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Title or Position | OWNER/DIEITIAN
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Name | DEBORAH PEPPER-DOUGHERTY
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Credential | RDN, LD
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Telephone | 207-781-4922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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