Provider Demographics
NPI:1598062549
Name:KEMP, WENDY SUSAN (RD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:SUSAN
Last Name:KEMP
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 FAIRWAY CIR
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-2567
Mailing Address - Country:US
Mailing Address - Phone:508-254-1020
Mailing Address - Fax:
Practice Address - Street 1:46 FAIRWAY CIR
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-2567
Practice Address - Country:US
Practice Address - Phone:508-254-1020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-26
Last Update Date:2011-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6221133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered