Provider Demographics
NPI:1811479520
Name:GRELA, DANIELLE MARIA (RDN, LDN)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MARIA
Last Name:GRELA
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:MARIA
Other - Last Name:MASTALERZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN, LDN
Mailing Address - Street 1:20 WYNNE ST
Mailing Address - Street 2:
Mailing Address - City:SEEKONK
Mailing Address - State:MA
Mailing Address - Zip Code:02771-4807
Mailing Address - Country:US
Mailing Address - Phone:401-359-0806
Mailing Address - Fax:
Practice Address - Street 1:20 WYNNE ST
Practice Address - Street 2:
Practice Address - City:SEEKONK
Practice Address - State:MA
Practice Address - Zip Code:02771-4807
Practice Address - Country:US
Practice Address - Phone:401-359-0806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4345133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered