Provider Demographics
NPI:1326241068
Name:LEBRE, MONICA P (MS, RD, LDN)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:P
Last Name:LEBRE
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:PO BOX 1013
Mailing Address - Street 2:
Mailing Address - City:WRENTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02093-9013
Mailing Address - Country:US
Mailing Address - Phone:774-847-1576
Mailing Address - Fax:
Practice Address - Street 1:129 HAMILTON RD
Practice Address - Street 2:
Practice Address - City:WRENTHAM
Practice Address - State:MA
Practice Address - Zip Code:02093-1310
Practice Address - Country:US
Practice Address - Phone:774-847-9419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2161133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered