Amanda Maria Laezza, RDN
Dietitian, Registered in Providence, RI. Individual provider (NPI-1).
NPI number1124887971
StatusActive
Last updated in NPPESJun 17, 2024
Details
- NPI
- 1124887971
- Entity type
- Individual (NPI-1)
- Name
- Amanda Maria Laezza
- Credential
- RDN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 14, 2024
- Certification date
- Jun 17, 2024
- Last updated
- Jun 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | – | – | Yes |
Practice location
383 W Fountain St Ste 115Providence, RI 02903-3515
Phone 401-297-3256
Mailing address
8 Fawn CtMonroe Twp, NJ 08831-1180
Phone 908-930-0353
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