Bonney Couper-Kiablick

Individual provider Active NPI Registered Dietitian · Pelham, MA

NPI 1619707437 · NPPES record last updated Aug 15, 2024

Key facts

NPI
1619707437
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
LDN7658 (MA)
Practice address
11 Enfield Rd
Pelham, MA 01002-9736
Phone
(413) 522-7568
NPI assigned
Aug 6, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LDN7658 MA Yes

Addresses

Primary practice location

11 Enfield Rd
Pelham, MA 01002-9736

Mailing address

11 Enfield Rd
Pelham, MA 01002-9736

Other providers in Pelham, MA

All providers in Pelham, MA · Registered Dietitian in Massachusetts

Sources for this page

Verify at the official NPI Registry.