Individual
MONICA WREN BABCOCK MANCUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPH, RD
Contact information
Practice address
1760 KIRTS BLVD APT 107, TROY, MI 48084-4342
(248) 860-4853
Mailing address
30680 GLENMUER ST, FARMINGTON HILLS, MI 48334-1027
(248) 860-4853
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86068236
MI
Other
Enumeration date
04/25/2020
Last updated
03/18/2025
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