Provider Demographics
NPI:1881295764
Name:IGOE, CLAIRE HELEN (RD, LDN)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:HELEN
Last Name:IGOE
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 E PARK AVE
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-2653
Mailing Address - Country:US
Mailing Address - Phone:850-765-6769
Mailing Address - Fax:
Practice Address - Street 1:1202 E PARK AVE
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-2653
Practice Address - Country:US
Practice Address - Phone:850-765-6769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND9432133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered