Provider Demographics
NPI:1720613326
Name:LEHANE, EMILY LAUREN (MS, RD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:LAUREN
Last Name:LEHANE
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 1:31 TURNER ST APT 3
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2885
Mailing Address - Country:US
Mailing Address - Phone:617-388-2221
Mailing Address - Fax:
Practice Address - Street 1:343 MAIN ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-3616
Practice Address - Country:US
Practice Address - Phone:617-596-0321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86143646133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered