Individual
MRS. GWEN GLORIA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
25 ASHLEY ST, PEPPERELL, MA 01463-4206
(978) 257-3962
Mailing address
25 ASHLEY ST, PEPPERELL, MA 01463-4206
(978) 257-3962
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
77
MA
Other
Enumeration date
02/18/2021
Last updated
02/18/2021
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