Individual
SARVNAZ MODARRESI GHAVAMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,RDN, LDN
Contact information
Practice address
5 COMMERCIAL DR UNIT 1204, LAKEVILLE, MA 02347-1745
(413) 992-7603
Mailing address
5 COMMERCIAL DR UNIT 1204, LAKEVILLE, MA 02347-1745
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
4027
MA
Other
Enumeration date
12/07/2016
Last updated
12/07/2016
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