Organization
BODY SCULPT AND NUTRITION CONSULTING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NORAH ALILA OTIENO-WASONGA (RDN)
(508) 371-7297
Entity
Organization
Contact information
Practice address
500 N MAIN STREET, UNIT D, SUITE #202, RANDOLPH, MA 02368-2020
(781) 728-5783
Mailing address
500 N MAIN STREET, UNIT D, SUITE #202, RANDOLPH, MA 02368-2020
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5534
LICENSE
MA
Enumeration date
10/17/2022
Last updated
05/17/2024
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