Provider Demographics
NPI:1124501812
Name:OECHSLE, LINDA (CN)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:OECHSLE
Suffix:
Gender:F
Credentials:CN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 BENHAM ST
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-1924
Mailing Address - Country:US
Mailing Address - Phone:203-645-1814
Mailing Address - Fax:
Practice Address - Street 1:1021 BENHAM ST
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-1924
Practice Address - Country:US
Practice Address - Phone:203-645-1814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001608133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist