Individual
COURTNEY C BRASWELL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
R.D.L.D.
Contact information
Practice address
825 CHALKSTONE AVE, PROVIDENCE, RI 02908-4728
(401) 456-2277
(401) 456-6718
Mailing address
825 CHALKSTONE AVE, PROVIDENCE, RI 02908-4728
(401) 456-2277
(401) 456-6718
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
LDN00562
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29929-7
BLUE CROSS
RI
01
—
412908
BLUE CHIP
RI
Enumeration date
11/15/2005
Last updated
07/08/2007
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