Provider Demographics
NPI:1366601098
Name:CRICCO, CATHERINE H (RD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:H
Last Name:CRICCO
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 1:364 FREEMAN RD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03781-5019
Mailing Address - Country:US
Mailing Address - Phone:603-675-5708
Mailing Address - Fax:603-543-1323
Practice Address - Street 1:364 FREEMAN RD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NH
Practice Address - Zip Code:03781-5019
Practice Address - Country:US
Practice Address - Phone:603-675-5708
Practice Address - Fax:603-543-1323
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH618193133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered