| NPI | 1669905311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA STASIO COSTA Owner/Operator 781-864-4645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NY 008021) |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2017-04-10 |