Individual
STAVROULA MANOUSOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(617) 665-2229
Mailing address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(617) 665-2229
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1261
MA
Other
Enumeration date
07/18/2007
Last updated
07/18/2007
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