Provider Demographics
NPI:1962066423
Name:JASCOT, DANNIELLE LYNN (MS)
Entity type:Individual
Prefix:MRS
First Name:DANNIELLE
Middle Name:LYNN
Last Name:JASCOT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 STABLE LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-2131
Mailing Address - Country:US
Mailing Address - Phone:860-344-0377
Mailing Address - Fax:
Practice Address - Street 1:31 STABLE LN
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-2131
Practice Address - Country:US
Practice Address - Phone:860-344-0377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist