Individual
MRS. MARY WEBSTER-BAUBLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD LDN
Contact information
Practice address
235 N PEARL ST, BROCKTON, MA 02301-1794
(508) 427-3011
Mailing address
20 JASON LN, MANSFIELD, MA 02048-3449
(508) 337-8967
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
732
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
732
DIETITIAN LICENSE NUMBER
MA
01
—
R607640
REGISTRATION NUMBER
MA
Enumeration date
10/11/2006
Last updated
07/08/2007
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