Individual
MS. ROSLYN D GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LDN, CDE
Contact information
Practice address
444 WESTMINSTER STREET, PROVIDENCE, RI 02903-3279
(401) 459-1573
(401) 459-5804
Mailing address
168 MAPLEWOOD AVE, CRANSTON, RI 02920-7645
(401) 944-2676
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
842
MA
133V00000X
Registered Dietitian
Primary
LDN00578
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LD0153
BLUE CROSS & BLUE SHIELD
MA
Enumeration date
05/01/2007
Last updated
07/08/2007
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