Individual
MAIA ROSE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, CDN
Contact information
Practice address
310 BOSTON POST RD UNIT 163, WATERFORD, CT 06385-1969
(860) 912-8079
Mailing address
310 BOSTON POST RD UNIT 163, WATERFORD, CT 06385-1969
(860) 912-8079
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2414
CT
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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