Provider Demographics
NPI:1417408469
Name:BRIARD, DANIELLE (RD, MS)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:BRIARD
Suffix:
Gender:F
Credentials:RD, MS
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 3514
Mailing Address - Street 2:
Mailing Address - City:NANTUCKET
Mailing Address - State:MA
Mailing Address - Zip Code:02584-3514
Mailing Address - Country:US
Mailing Address - Phone:508-292-7730
Mailing Address - Fax:
Practice Address - Street 1:6 ARROWHEAD DR
Practice Address - Street 2:
Practice Address - City:NANTUCKET
Practice Address - State:MA
Practice Address - Zip Code:02554-3105
Practice Address - Country:US
Practice Address - Phone:508-292-7730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1020105133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered