Individual
JACQUELINE MINICHIELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
398 NEPONSET AVE, DORCHESTER, MA 02122-3134
(617) 282-3200
(617) 282-8201
Mailing address
1135 MORTON ST, MATTAPAN, MA 02126-2834
(617) 533-2300
(617) 282-8201
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3380
MA
Other
Enumeration date
09/28/2012
Last updated
09/28/2012
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