Provider Demographics
NPI:1669943015
Name:GIACCO, CARA NOLAN (RDN, LDN)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:NOLAN
Last Name:GIACCO
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:NOLAN
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:99 M ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02127-3194
Mailing Address - Country:US
Mailing Address - Phone:518-469-8418
Mailing Address - Fax:
Practice Address - Street 1:99 M ST UNIT 2
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127-3194
Practice Address - Country:US
Practice Address - Phone:518-469-8418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-11
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered