Provider Demographics
NPI:1093523532
Name:JALBERT, MEGAN KELSEY (RDN)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:KELSEY
Last Name:JALBERT
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 FOREST RD
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-3009
Mailing Address - Country:US
Mailing Address - Phone:203-343-6418
Mailing Address - Fax:
Practice Address - Street 1:35 FOREST RD
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-3009
Practice Address - Country:US
Practice Address - Phone:203-343-6418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT86068145133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered