Provider Demographics
NPI:1134469901
Name:RAYMOND, JOANNA MARIE (MS, RD, LDN)
Entity Type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:MARIE
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3520 QUAKER LN
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-3007
Mailing Address - Country:US
Mailing Address - Phone:401-578-9087
Mailing Address - Fax:
Practice Address - Street 1:3520 QUAKER LN
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-3007
Practice Address - Country:US
Practice Address - Phone:401-578-9087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-15
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI00736133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered