Lisa Diffley, RD

Individual provider Active NPI Registered Dietitian · East Taunton, MA

NPI 1811768005 · NPPES record last updated Jan 16, 2024

Key facts

NPI
1811768005
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
804230 (MA)
Practice address
88 Old Colony Ave
East Taunton, MA 02718-1114
Phone
(508) 207-3099
NPI assigned
Jan 16, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
804230MAMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 804230 MA Yes

Addresses

Primary practice location

88 Old Colony Ave
East Taunton, MA 02718-1114

Mailing address

88 Old Colony Ave
East Taunton, MA 02718-1114
Phone (508) 207-3099

Other providers in East Taunton, MA

All providers in East Taunton, MA · Registered Dietitian in Massachusetts

Sources for this page

Verify at the official NPI Registry.