Provider Demographics
NPI:1568240950
Name:RAFFAELE, NINA MARGARITA (NBHWC CERTIFICATION)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:MARGARITA
Last Name:RAFFAELE
Suffix:
Gender:F
Credentials:NBHWC CERTIFICATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:371 ROUTE 28 APT 15
Mailing Address - Street 2:
Mailing Address - City:HARWICH PORT
Mailing Address - State:MA
Mailing Address - Zip Code:02646-1629
Mailing Address - Country:US
Mailing Address - Phone:774-408-8689
Mailing Address - Fax:
Practice Address - Street 1:371 ROUTE 28 APT 15
Practice Address - Street 2:
Practice Address - City:HARWICH PORT
Practice Address - State:MA
Practice Address - Zip Code:02646-1629
Practice Address - Country:US
Practice Address - Phone:774-768-3087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAA-3696041171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty