MIREILLE BLACKE

MIDDLETOWN, CT
NPI1861768889
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: CT  1073878)
Additional Taxonomies133NN1002X Nutritionist, Nutrition, Education
(Licence: CT  001082)
Enumeration Date2012-03-23
Last Update Date2012-03-23
Business Address
-- MIREILLE BLACKE MA, RD, CD-N
6122 TOWN RDG
MIDDLETOWN, CT 06457-6551
Phone number: 203-233-6680
Mailing Address
-- MIREILLE BLACKE MA, RD, CD-N
6122 TOWN RDG
MIDDLETOWN, CT 06457-6551
Phone number: 203-233-6680