Provider Demographics
NPI:1821388315
Name:VIENS, RACHEL AUGUSTA (RD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:AUGUSTA
Last Name:VIENS
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 1:3010 VERONA CT
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-8983
Mailing Address - Country:US
Mailing Address - Phone:315-708-9345
Mailing Address - Fax:
Practice Address - Street 1:3010 VERONA CT
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027-8983
Practice Address - Country:US
Practice Address - Phone:315-708-9345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00933568133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered