Individual
AMELIA POLISENO GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-5603
(401) 444-6360
Mailing address
117 ELLENFIELD ST, PROVIDENCE, RI 02905-4541
(401) 444-5640
(401) 444-5462
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
LDN01101
RI
Other
Enumeration date
03/16/2021
Last updated
03/16/2021
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