Individual
LYSSA MERRIAM PETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,RD,LDN
Contact information
Practice address
CARITAS HOLY FAMILY HOSPITAL 70 EAST STREET, CONVENT BUILDING, METHUEN, MA 01844
(978) 687-0156
(978) 681-9075
Mailing address
13 PINECREST RD, ANDOVER, MA 01810-5712
(978) 687-0156
(978) 681-9075
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
826
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
701743
CDR ID #
MA
01
—
826
DIETITIAN LICENSE #
MA
Enumeration date
09/21/2006
Last updated
07/08/2007
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