Provider Demographics
NPI:1649412008
Name:MUNSELL, JANICE L (LDN)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:L
Last Name:MUNSELL
Suffix:
Gender:F
Credentials:LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 789
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:MA
Mailing Address - Zip Code:01056-0789
Mailing Address - Country:US
Mailing Address - Phone:413-509-1000
Mailing Address - Fax:413-509-1003
Practice Address - Street 1:14 S WESTFIELD ST
Practice Address - Street 2:
Practice Address - City:FEEDING HILLS
Practice Address - State:MA
Practice Address - Zip Code:01030-2702
Practice Address - Country:US
Practice Address - Phone:413-786-2957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-01
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1204133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist