Provider Demographics
NPI:1992957351
Name:JUNERED, S SUZANNE (RD)
Entity type:Individual
Prefix:
First Name:S SUZANNE
Middle Name:
Last Name:JUNERED
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 1:2885 AURORA AVE
Mailing Address - Street 2:UNIT 31
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-2250
Mailing Address - Country:US
Mailing Address - Phone:303-440-1015
Mailing Address - Fax:303-440-8990
Practice Address - Street 1:2885 AURORA AVE
Practice Address - Street 2:UNIT 31
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-2250
Practice Address - Country:US
Practice Address - Phone:303-440-1015
Practice Address - Fax:303-440-8990
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
932302133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered