Provider Demographics
NPI:1497864565
Name:PRECOURT, ALISON SWANSON (RD,CD,CDE)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:SWANSON
Last Name:PRECOURT
Suffix:
Gender:F
Credentials:RD,CD,CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 WINTER HAVEN RD
Mailing Address - Street 2:
Mailing Address - City:SHELBURNE
Mailing Address - State:VT
Mailing Address - Zip Code:05482-6551
Mailing Address - Country:US
Mailing Address - Phone:802-985-8606
Mailing Address - Fax:
Practice Address - Street 1:111 COLCHESTER AVE
Practice Address - Street 2:NUTRITION SERVICES
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1473
Practice Address - Country:US
Practice Address - Phone:802-847-5646
Practice Address - Fax:802-847-2790
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT074-0000072133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric