Individual
MS. JOHANNA LEIGH EARLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
33 NEWPORT AVE APT 505, QUINCY, MA 02171-2678
(860) 338-5863
Mailing address
33 NEWPORT AVE APT 505, QUINCY, MA 02171-2678
(860) 338-5863
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
DT91588
TX
133V00000X
Registered Dietitian
Primary
LDN6812
MA
Other
Enumeration date
02/22/2022
Last updated
01/06/2025
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