Provider Demographics
NPI:1326236787
Name:HARRIS, CAROLE ANNE (RD LDN)
Entity Type:Individual
Prefix:MS
First Name:CAROLE
Middle Name:ANNE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RD LDN
Other - Prefix:MS
Other - First Name:CAROLE
Other - Middle Name:ANNE
Other - Last Name:GRANDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN LDN
Mailing Address - Street 1:29 BROOKVIEW ROAD
Mailing Address - Street 2:
Mailing Address - City:BOXFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01921
Mailing Address - Country:US
Mailing Address - Phone:508-479-1446
Mailing Address - Fax:978-887-3804
Practice Address - Street 1:29 BROOKVIEW ROAD
Practice Address - Street 2:
Practice Address - City:BOXFORD
Practice Address - State:MA
Practice Address - Zip Code:01921
Practice Address - Country:US
Practice Address - Phone:508-479-1446
Practice Address - Fax:978-887-3804
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA829133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered