Individual
BONITA M. HATHAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
242 GREEN ST, GARDNER, MA 01440-1336
(978) 630-6289
(978) 630-6820
Mailing address
242 GREEN ST, GARDNER, MA 01440-1336
(978) 630-6289
(978) 630-6820
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
284967
MA
Other
Enumeration date
03/09/2007
Last updated
08/13/2010
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