Provider Demographics
NPI:1013551050
Name:BRENNAN, CATHERINE MACLAUGHLIN (RDN, CLC)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:MACLAUGHLIN
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:RDN, CLC
Other - Prefix:MS
Other - First Name:CATHERINE
Other - Middle Name:MACLAUGHLIN
Other - Last Name:BRENNAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RDN, CLC
Mailing Address - Street 1:238 NARRAGANSETT AVE
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02835
Mailing Address - Country:US
Mailing Address - Phone:401-442-7258
Mailing Address - Fax:
Practice Address - Street 1:238 NARRAGANSETT AVE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:RI
Practice Address - Zip Code:02835-1169
Practice Address - Country:US
Practice Address - Phone:401-442-7258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-02
Last Update Date:2019-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILDN00968133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty