Individual
EMILY BOUSQUIN SULLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RDN, LDN
Contact information
Practice address
3 BOW ST, CAMBRIDGE, MA 02138-5109
(617) 547-2255
(617) 547-0003
Mailing address
3 BOW ST, CAMBRIDGE, MA 02138-5109
(617) 547-2255
(617) 547-0003
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
4916-NU-NU
MA
Other
Enumeration date
11/27/2019
Last updated
11/27/2019
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