Individual
MS. TRISHA BROOKE STAVINOHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
BUILDING 42, KANSAS STREET, NATICK, MA 01760
(508) 233-4305
Mailing address
30 HARVARD ST # 2, NATICK, MA 01760-3537
(508) 545-0358
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT05909
TX
Other
Enumeration date
10/11/2006
Last updated
07/08/2007
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