Provider Demographics
NPI:1215396528
Name:ROBINSON, TARA LEIGH (RD)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:LEIGH
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 1:67 ELM ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-1540
Mailing Address - Country:US
Mailing Address - Phone:508-404-8170
Mailing Address - Fax:
Practice Address - Street 1:38 VANDERBILT AVE
Practice Address - Street 2:UNIT E
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-5006
Practice Address - Country:US
Practice Address - Phone:781-269-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-15
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3990133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered