Provider Demographics
NPI:1174134670
Name:FROEBEL, MOLLY (MS NUTRITION)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:FROEBEL
Suffix:
Gender:F
Credentials:MS NUTRITION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 E PEACHAM RD
Mailing Address - Street 2:
Mailing Address - City:PEACHAM
Mailing Address - State:VT
Mailing Address - Zip Code:05862-7900
Mailing Address - Country:US
Mailing Address - Phone:802-477-2743
Mailing Address - Fax:
Practice Address - Street 1:1619 E PEACHAM RD
Practice Address - Street 2:
Practice Address - City:PEACHAM
Practice Address - State:VT
Practice Address - Zip Code:05862-7900
Practice Address - Country:US
Practice Address - Phone:802-477-2743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist