Provider Demographics
NPI:1235944653
Name:GARRISON, ANNA (RDN, LDN)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:GARRISON
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 COTTAGE ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02128-2205
Mailing Address - Country:US
Mailing Address - Phone:603-714-9065
Mailing Address - Fax:
Practice Address - Street 1:34 COTTAGE ST APT 1
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02128-2205
Practice Address - Country:US
Practice Address - Phone:603-714-9065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALDN7980133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered