Provider Demographics
NPI:1447364864
Name:MCCLARENCE, HELEN V (RD LDN M ED)
Entity type:Individual
Prefix:MS
First Name:HELEN
Middle Name:V
Last Name:MCCLARENCE
Suffix:
Gender:F
Credentials:RD LDN M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:23 NORFOLK ST
Mailing Address - Street 2:APT 1
Mailing Address - City:ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02119-3508
Mailing Address - Country:US
Mailing Address - Phone:781-687-3209
Mailing Address - Fax:
Practice Address - Street 1:200 SPRINGS RD
Practice Address - Street 2:EDITH NOURSE ROGERS MEMORIAL VETERANS HOSPITAL
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-1114
Practice Address - Country:US
Practice Address - Phone:781-687-3209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA590133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered