Individual
LISA C VAN DUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LDN
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 856-2492
(508) 856-8020
Mailing address
13 RADFORD RD, PRINCETON, MA 01541-1806
(978) 464-5307
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
575
MA
Other
Enumeration date
12/19/2006
Last updated
07/08/2007
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