Provider Demographics
NPI:1013057835
Name:STOPPER, DEBRA ANNE I (RD, CD-N)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ANNE
Last Name:STOPPER
Suffix:I
Gender:F
Credentials:RD, CD-N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 SIDE HILL RD
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-3025
Mailing Address - Country:US
Mailing Address - Phone:203-287-8781
Mailing Address - Fax:
Practice Address - Street 1:1 EVERGREEN AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-2717
Practice Address - Country:US
Practice Address - Phone:203-248-8047
Practice Address - Fax:203-248-8047
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000043133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered