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Individual

KEELY BOURASSA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
1200 S CENTER ST, TERRE HAUTE, IN 47802-1118
(317) 753-7308
Mailing address
1200 S CENTER ST, TERRE HAUTE, IN 47802-1118
(317) 753-7308

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37003359A
IN

Other

Enumeration date
04/14/2023
Last updated
04/21/2023
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