Individual
KIMBERLY MICHELLE CONCRA
Active
Individual
KIMBERLY MICHELLE CONCRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDN
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
887
MA
133NN1002X
Nutrition Education Nutritionist
887
MA
133V00000X
Registered Dietitian
887
MA
Other
Enumeration date
06/10/2024
Last updated
06/10/2024
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