Organization Name: | PATTY RAIS-KEELEY RD, LDN, CDE, LLC |
NPI Number: | 1861817520 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PATTY RAIS-KEELEY (PROPRIETOR) |
Mailing Address: | 220-1 Reservoir St. Needham Heights |
State: | MA US |
Postal Code: | 02494 |
Phone Number: | 6173658257 |
Fax Number: | 7814440079 |
NPI Enumeration Date: | 03/04/2014 |
NPI Last Update Date: | 03/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133NN1002X |
License Number: | 292 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Nutritionist |
Taxonomy Specialization: | Nutrition, Education |
Taxonomy Definition: |