Individual
CHRISTINA BOGARDUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
85 HERRICK ST, BEVERLY, MA 01915-1790
(978) 922-3000
Mailing address
85 HERRICK ST, BEVERLY, MA 01915-1790
(978) 922-3000
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3420
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3420
COMMONWEALTH OF MASSACHUSETTS DIVISION OF LICENSURE BOARD OF DIETITIANS
MA
Enumeration date
12/07/2015
Last updated
12/07/2015
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