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General NPI Number Information
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NPI Number | 1952865693
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Entity Type | Individual
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Provider Name | RACHEL JANE TEDFORD RDN, LDN
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Gender | Female
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Dates
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Enumeration Date | 01/28/2019
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Last Update Date | 01/28/2019
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Provider Practice Location Address
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Address Line | 35 INDEPENDENCE WAY
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City | DANVERS
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State | MA
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Zip | 01923-5535
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Country | US
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Telephone | 978-791-0740
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Fax |
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Provider Business Mailing Address
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Address Line | 10 HARDWOOD DR
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City | NORTH BILLERICA
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State | MA
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Zip | 01862-1254
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 2018-000228-NU-A
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License Number State | MA
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