Individual
STACY KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPH,RD,LDN
Contact information
Practice address
1404 COMMONWEALTH AVE, #4, BRIGHTON, MA 02135-3722
(617) 713-2835
(617) 632-4095
Mailing address
1404 COMMONWEALTH AVE, BRIGHTON, MA 02135-3722
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1287
MA
133V00000X
Registered Dietitian
1338
NH
133V00000X
Registered Dietitian
DI1769
ME
Other
Enumeration date
08/08/2006
Last updated
11/03/2022
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