Provider Demographics
NPI:1013318096
Name:DOUCETTE, DEBORAH KENNEDY (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:KENNEDY
Last Name:DOUCETTE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:130 WEATHERLY TRL
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-1203
Mailing Address - Country:US
Mailing Address - Phone:203-430-4899
Mailing Address - Fax:
Practice Address - Street 1:130 WEATHERLY TRL
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-1203
Practice Address - Country:US
Practice Address - Phone:203-430-4899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education