Provider Demographics
NPI:1881116036
Name:HAINES, CAITLIN (RD CNSC)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:HAINES
Suffix:
Gender:F
Credentials:RD CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 PLEASANT ST STE 201
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-6534
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:94 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-6535
Practice Address - Country:US
Practice Address - Phone:508-205-9594
Practice Address - Fax:617-539-2458
Is Sole Proprietor?:No
Enumeration Date:2017-07-10
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1422133V00000X
MI86021985133V00000X
MA6742133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered