Organization
BEHAVIORAL NUTRITION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELE QUINLAN LMHC (CLINICAL SUPERVISOR)
(617) 372-3733
Entity
Organization
Contact information
Practice address
1266 FURNACE BROOK PKWY, SUITE 404, QUINCY, MA 02169-4758
(617) 595-7044
(888) 434-5097
Mailing address
1266 FURNACE BROOK PKWY, SUITE 404, QUINCY, MA 02169-4758
(617) 595-7044
(888) 434-5097
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
5757
MA
101YM0800X
Mental Health Counselor
Primary
5757
MA
101YP2500X
Professional Counselor
5757
MA
103TP0016X
Prescribing (Medical) Psychologist
75391
MA
133V00000X
Registered Dietitian
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
—
—
133VN1006X
Metabolic Nutrition Registered Dietitian
—
—
Other
Enumeration date
06/13/2011
Last updated
04/16/2020
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