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General NPI Number Information
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NPI Number | 1518564582
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Entity Type | Individual
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Provider Name | LUCIANA AMBROSI SLEIGHT MS RD
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Gender | Female
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Dates
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Enumeration Date | 10/02/2020
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Last Update Date | 10/02/2020
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Provider Practice Location Address
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Address Line | SANTA CRUZ
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City | RADA TILLY
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State | CHUBUT
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Zip | 09001
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Country | AR
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Telephone | 617-982-2339
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Fax |
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Provider Business Mailing Address
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Address Line | 2 INVERNESS LN
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City | PLYMOUTH
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State | MA
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Zip | 02360-3176
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Country | US
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Telephone | 617-982-2338
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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