Individual
MS. KATHLEEN MARY RUTH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(774) 443-3887
Mailing address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(774) 443-3887
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
01010372
MA
Other
Enumeration date
05/19/2009
Last updated
05/19/2009
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