Organization
OLIVE BRANCH NUTRITION THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAILA SHANAA RDN (OWNER)
(508) 688-0456
Entity
Organization
Contact information
Practice address
20 MESSER ST # 4, PROVIDENCE, RI 02909-2006
(508) 688-0456
Mailing address
20 MESSER ST # 4, PROVIDENCE, RI 02909-2006
(508) 688-0456
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
10/06/2021
Last updated
10/06/2021
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