Individual
JEANNINE BALBIERS SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
3297 WASHINGTON ST, JAMAICA PLAIN, MA 02130-2655
(617) 983-6050
Mailing address
70 HOPE AVE, SUITE 102, WALTHAM, MA 02453-2732
(617) 983-6050
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
580
MA
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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