Individual
MACKENZIE ANNE BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
450 VETERANS MEMORIAL PKWY STE 8C, EAST PROVIDENCE, RI 02914-5300
(401) 396-9331
Mailing address
450 VETERANS MEMORIAL PKWY, STE 8C, EAST PROVIDENCE, RI 02914-5300
(434) 203-3004
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LDN00993
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86099726
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
11/19/2018
Last updated
12/28/2018
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