Provider Demographics
NPI:1649028465
Name:BAGGOT, ALLISON MARIE (RD)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:MARIE
Last Name:BAGGOT
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 1:110 N LIVINGSTON ST APT 120
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-2876
Mailing Address - Country:US
Mailing Address - Phone:507-649-7349
Mailing Address - Fax:
Practice Address - Street 1:110 N LIVINGSTON ST APT 120
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-2876
Practice Address - Country:US
Practice Address - Phone:507-649-7349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5232-29133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered