Organization
C.L.U.B BLESSED WEIGHT MANAGEMENT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE JEAN BARBOZA CERTIFIED (FITNESS & NUTRITION SPECIALIST)
(774) 379-9761
Entity
Organization
Contact information
Practice address
250 MAIN ST, PAWTUCKET, RI 02860-4016
(774) 379-9761
Mailing address
102 MOORE ST, PROVIDENCE, RI 02907-1505
(774) 379-9761
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
305S00000X
Point of Service
—
—
Other
Enumeration date
08/04/2020
Last updated
08/04/2020
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