Provider Demographics
NPI:1609474840
Name:FOLLETT, MAI SING (RD)
Entity Type:Individual
Prefix:
First Name:MAI SING
Middle Name:
Last Name:FOLLETT
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 1:2320 LARUE LN
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54313-5797
Mailing Address - Country:US
Mailing Address - Phone:920-562-3688
Mailing Address - Fax:
Practice Address - Street 1:3014 ERIE AVE
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-3696
Practice Address - Country:US
Practice Address - Phone:920-459-3028
Practice Address - Fax:920-453-7052
Is Sole Proprietor?:No
Enumeration Date:2020-10-10
Last Update Date:2020-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered