Provider Demographics
NPI:1639054059
Name:UGGEN, SHELBY (MS, RD, LDN)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:UGGEN
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 PARK DR APT 1B
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-3840
Mailing Address - Country:US
Mailing Address - Phone:817-307-3701
Mailing Address - Fax:
Practice Address - Street 1:1000 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:NEEDHAM HEIGHTS
Practice Address - State:MA
Practice Address - Zip Code:02494-1262
Practice Address - Country:US
Practice Address - Phone:781-343-1592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALDN8299133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered