Individual
LESLIE ANNE SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
55 LAKE AVE N, DEPARTMENT OF NUTRITION AND FOOD SERVICES, WORCESTER, MA 01655-0002
(508) 334-4572
Mailing address
1600 BEACON ST APT 512, BROOKLINE, BROOKLINE, MA 02446-2226
(617) 980-6056
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
2685
MA
Other
Enumeration date
01/16/2008
Last updated
01/16/2008
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