Individual
MARTA E BANUELOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CNS
Contact information
Practice address
504 BEACON ST STE 1, BOSTON, MA 02115-1042
(415) 999-8393
Mailing address
504 BEACON ST STE 1, BOSTON, MA 02115-1042
(617) 615-9198
(617) 616-0936
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
133V00000X
Registered Dietitian
Primary
19289
MA
Other
Enumeration date
11/09/2021
Last updated
07/02/2026
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