Individual
LAILA SHANAA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, LDN
Contact information
Practice address
109 CUSHING ST, WALTHAM, MA 02453-0426
(508) 688-0456
Mailing address
109 CUSHING ST, WALTHAM, MA 02453-0426
(508) 688-0456
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
4820-NU-NU
MA
Other
Enumeration date
07/16/2019
Last updated
07/16/2019
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