Provider Demographics
NPI:1437929718
Name:HAGGARD, RACHEL ALEXANDRA ELLEN (RD, LDN)
Entity Type:Individual
Prefix:MISS
First Name:RACHEL
Middle Name:ALEXANDRA ELLEN
Last Name:HAGGARD
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 WAYSIDE INN RD
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-3210
Mailing Address - Country:US
Mailing Address - Phone:978-460-0150
Mailing Address - Fax:
Practice Address - Street 1:220 WAYSIDE INN RD
Practice Address - Street 2:
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-3210
Practice Address - Country:US
Practice Address - Phone:978-460-0150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA86130761133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered