Bonney Couper-Kiablick
Dietitian, Registered in Pelham, MA. Individual provider (NPI-1).
NPI number1619707437
StatusActive
Last updated in NPPESAug 15, 2024
Details
- NPI
- 1619707437
- Entity type
- Individual (NPI-1)
- Name
- Bonney Couper-Kiablick
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 6, 2024
- Certification date
- Aug 15, 2024
- Last updated
- Aug 15, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | LDN7658 | MA | Yes |
Practice location
11 Enfield RdPelham, MA 01002-9736
Phone 413-522-7568
Mailing address
11 Enfield RdPelham, MA 01002-9736
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