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Individual

EMILY DACOSTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2551 N CLARK ST, CHICAGO, IL 60614-1798
(312) 533-1754
Mailing address
226 HAYES CT, LAVALLETTE, NJ 08735-3109

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND10107
FL

Other

Enumeration date
04/13/2022
Last updated
04/13/2022
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