Provider Demographics
NPI:1467169128
Name:MCLEAN, DEBORAH ANNE (RD)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ANNE
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 CROSBY DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-1462
Mailing Address - Country:US
Mailing Address - Phone:781-221-7018
Mailing Address - Fax:
Practice Address - Street 1:26 CROSBY DR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-1462
Practice Address - Country:US
Practice Address - Phone:781-221-7018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2042133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered