Provider Demographics
NPI:1053744011
Name:O'BRIEN, JULIA N (RD)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:N
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:N
Other - Last Name:CASSAVANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:167 POINT ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4771
Mailing Address - Country:US
Mailing Address - Phone:401-444-5640
Mailing Address - Fax:401-444-5462
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-444-6966
Practice Address - Fax:401-444-5462
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric