Individual
ANDREA K ACKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD IBCLC
Contact information
Practice address
383 W FOUNTAIN ST # 115, PROVIDENCE, RI 02903-3515
(401) 203-7248
Mailing address
171 FORGE RD, NORTH KINGSTOWN, RI 02852-1007
(518) 527-3213
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
928270
RI
174N00000X
Lactation Consultant (Non-RN)
L56279
RI
Other
Enumeration date
04/07/2014
Last updated
11/05/2025
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