Individual
KELLY SMALLCOMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
850 HARRISON AVE, BOSTON, MA 02118-4001
(617) 414-4595
Mailing address
11 PRINCE ST, UNIT 2, JAMAICA PLAIN, MA 02130-2725
(530) 902-7080
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
948573
MA
Other
Enumeration date
01/22/2007
Last updated
04/13/2010
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