Provider Demographics
NPI:1932619038
Name:DUQUETTE, ALEXANDRA (RD, CD)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:DUQUETTE
Suffix:
Gender:F
Credentials:RD, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 WASHINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05661-8973
Mailing Address - Country:US
Mailing Address - Phone:802-888-8233
Mailing Address - Fax:802-888-8239
Practice Address - Street 1:528 WASHINGTON HWY
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:VT
Practice Address - Zip Code:05661-8973
Practice Address - Country:US
Practice Address - Phone:802-888-8233
Practice Address - Fax:802-888-8239
Is Sole Proprietor?:No
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT074.0132064133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered