Healthcare Provider Details

I. General information

NPI: 1851362248
Provider Name (Legal Business Name): CYNTHIA MILNER WOODMAN M.S., R.D.N., L.D.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 05/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 MORSE CIR
SHIRLEY MA
01464-2908
US

IV. Provider business mailing address

16 MORSE CIR
SHIRLEY MA
01464-2908
US

V. Phone/Fax

Practice location:
  • Phone: 978-425-5785
  • Fax: 978-425-5783
Mailing address:
  • Phone: 978-425-5785
  • Fax: 978-425-5783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberNU772
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License NumberNU772
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: