Healthcare Provider Details

I. General information

NPI: 1043183221
Provider Name (Legal Business Name): DANIELLE TABER MS, RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 AIRPORT RD
WESTERLY RI
02891-3401
US

IV. Provider business mailing address

13 AIRPORT RD # 1030
WESTERLY RI
02891-3401
US

V. Phone/Fax

Practice location:
  • Phone: 401-284-6928
  • Fax:
Mailing address:
  • Phone: 401-284-6928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLDN00420
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: