Individual
KERRY COUGHLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(617) 784-6271
Mailing address
79 WALNUT ST APT 12, NEWTON, MA 02460-1345
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3396
MA
Other
Enumeration date
12/10/2012
Last updated
12/10/2012
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