Individual
MICHELLE BOUTET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, CSSD, LD
Contact information
Practice address
50 STANIFORD ST FL 10, BOSTON, MA 02114-2517
(617) 643-5903
Mailing address
50 STANIFORD ST FL 10, BOSTON, MA 02114-2517
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86034676
MA
Other
Enumeration date
08/15/2018
Last updated
08/15/2018
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