Organization
DISTINGUISHED DIETITIAN NUTRITIONIST PLLC
Active
Other names
Feed the Soul Nutrition
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE S BERRY-GARNSEY RD, CDE (PRESIDENT/CEO)
(315) 955-9998
Entity
Organization
Contact information
Practice address
312 SHERMAN STREET, WATERTOWN, NY 13601
(315) 955-9998
(315) 782-0386
Mailing address
312 SHERMAN STREET, WATERTOWN, NY 13601
(315) 955-9998
(315) 782-0386
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
005592
NY
Other
Enumeration date
06/02/2009
Last updated
06/07/2016
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