Provider Demographics
NPI:1245384049
Name:RICCI, DONNA JEANNE (MS, RD CNSC)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:JEANNE
Last Name:RICCI
Suffix:
Gender:F
Credentials:MS, RD CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-2853
Mailing Address - Country:US
Mailing Address - Phone:401-793-2603
Mailing Address - Fax:401-793-2606
Practice Address - Street 1:164 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-2853
Practice Address - Country:US
Practice Address - Phone:401-793-2603
Practice Address - Fax:401-793-2606
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI52133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered