Provider Demographics
NPI:1821412552
Name:MULVANEY, ALLISON L (MS, RD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:L
Last Name:MULVANEY
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 HARVARD ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-3800
Mailing Address - Country:US
Mailing Address - Phone:617-800-5616
Mailing Address - Fax:
Practice Address - Street 1:75 FINNELL DR
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02188-1110
Practice Address - Country:US
Practice Address - Phone:781-337-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-17
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3573133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered