Provider Demographics
NPI:1639593726
Name:RICHARDSON, RACHAEL ANNE (RD, LDN)
Entity Type:Individual
Prefix:MS
First Name:RACHAEL
Middle Name:ANNE
Last Name:RICHARDSON
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 1:133 NE 2ND AVE APT 1915
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-2914
Mailing Address - Country:US
Mailing Address - Phone:305-610-2006
Mailing Address - Fax:
Practice Address - Street 1:133 NE 2ND AVE APT 1915
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33132-2914
Practice Address - Country:US
Practice Address - Phone:305-610-2006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND4785133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered