Provider Demographics
NPI:1477201820
Name:DIEHL, CATHERINE JOY (MS, CNS)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:JOY
Last Name:DIEHL
Suffix:
Gender:F
Credentials:MS, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 WOOLSLEY AVE
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-4460
Mailing Address - Country:US
Mailing Address - Phone:203-858-4615
Mailing Address - Fax:
Practice Address - Street 1:98 WOOLSLEY AVE
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4460
Practice Address - Country:US
Practice Address - Phone:203-858-4615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCNS18138133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist