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General NPI Number Information
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NPI Number | 1730980483
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Entity Type | Organization
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Legal Business Name | KRISTINE BERUBE WELLNESS
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 3 OAKDALE ST APT 2
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City | JAMAICA PLAIN
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State | MA
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Zip | 02130-5104
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Country | US
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Telephone | 978-340-8834
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Fax |
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Provider Business Mailing Address
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Address Line | 3 OAKDALE ST APT 2
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City | JAMAICA PLAIN
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State | MA
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Zip | 02130-5104
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Country | US
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Telephone | 978-340-8834
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Fax |
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Authorized Official
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Title or Position | PRACTICE OWNER/REGISTERED DIETITIAN
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Name | KRISTINE BERUBE
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Credential | RD, LDN
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Telephone | 978-340-8834
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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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