Organization
A HEALTHY BALANCE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NICOLE L. TIERNEY LN (PRESIDENT)
(617) 479-0500
Entity
Organization
Contact information
Practice address
14B ALLEYNE STREET, QUINCY, MA 02169-2009
(617) 479-0500
(617) 302-2144
Mailing address
14B ALLEYNE STREET, QUINCY, MA 02169-2009
(617) 479-0500
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2917
MA
133V00000X
Registered Dietitian
3125
MA
133V00000X
Registered Dietitian
3397
MA
133V00000X
Registered Dietitian
3401
MA
Other
Enumeration date
10/29/2012
Last updated
12/05/2012
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