LISHA ANDREW

PROVIDENCE, RI
NPI1164992558
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: RI  LDN00982)
Additional Taxonomies133V00000X Dietitian, Registered
(Licence: MA  4627-NU-NU)
Enumeration Date2018-11-28
Last Update Date2018-11-28
Business Address
LISHA ANDREW
164 SUMMIT AVE
PROVIDENCE, RI 02906-2894
Phone number: 401-793-4719
Mailing Address
LISHA ANDREW
164 SUMMIT AVE
PROVIDENCE, RI 02906-2894
Phone number: 401-793-4719