Provider Demographics
NPI:1619145356
Name:TALIAFERRO, JILL WHITNEY (RD)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:WHITNEY
Last Name:TALIAFERRO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 TIFFANY ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-6304
Mailing Address - Country:US
Mailing Address - Phone:617-817-8871
Mailing Address - Fax:
Practice Address - Street 1:228 TIFFANY ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-6304
Practice Address - Country:US
Practice Address - Phone:617-817-8871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA960133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered