Provider Demographics
NPI:1619654944
Name:RAINVILLE, MORGAN (RDN, LD)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:RAINVILLE
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 JONATHAN AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-7330
Mailing Address - Country:US
Mailing Address - Phone:513-702-6698
Mailing Address - Fax:
Practice Address - Street 1:142 W TWIN OAKS TER
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-7132
Practice Address - Country:US
Practice Address - Phone:802-658-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT074.0109160133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered