Individual
MRS. DIANE H. HANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1653
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LD0169
BCBSMA LDN ANCILLARY PROV
MA
Enumeration date
05/31/2005
Last updated
10/30/2008
Update your record
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