Provider Demographics
NPI:1083216428
Name:ROBINSON, BROOKE (RD)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 MAIN ST STE 3
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-1507
Mailing Address - Country:US
Mailing Address - Phone:207-358-9887
Mailing Address - Fax:
Practice Address - Street 1:176 MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-1507
Practice Address - Country:US
Practice Address - Phone:207-358-9887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-11
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered