Individual
STACEY ELIZABETH CARREIRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
825 CHALKSTONE AVE, PROVIDENCE, RI 02908-4728
(401) 456-2000
Mailing address
30 TORI LEIGH LN, REHOBOTH, MA 02769-1545
(401) 368-7767
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3544
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S79563737
LICENSE NUMBER
MA
Enumeration date
02/13/2014
Last updated
02/13/2014
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