Individual
KELLY HANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
3297 WASHINGTON ST, JAMAICA PLAIN, MA 02130-2655
(617) 983-6044
Mailing address
3297 WASHINGTON ST, JAMAICA PLAIN, MA 02130-2655
(206) 696-4121
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3715
MA
Other
Enumeration date
06/10/2015
Last updated
06/10/2015
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