Provider Demographics
NPI:1740479682
Name:OUELLETTE, ERICA CINTRON (RD, LDN)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:CINTRON
Last Name:OUELLETTE
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 1:15 EISENHOWER RD
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-2722
Mailing Address - Country:US
Mailing Address - Phone:774-279-0391
Mailing Address - Fax:508-650-7540
Practice Address - Street 1:147 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:MA
Practice Address - Zip Code:01949
Practice Address - Country:US
Practice Address - Phone:978-774-2555
Practice Address - Fax:978-774-8715
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA926862133V00000X
MA2587133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist