Individual
MS. JOANN FARIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., R.D., L.D.N.
Contact information
Practice address
108 EVANS AVE, TIVERTON, RI 02878-4328
(410) 624-2266
Mailing address
108 EVANS AVE, TIVERTON, RI 02878-4328
(410) 624-2266
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
1252
MA
133V00000X
Registered Dietitian
Primary
LDN00115
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
207050
BLUE CROSS BLUE SHIELD RI
RI
01
—
404253
BLUE CHIP RI
RI
01
—
6300023
UNITED HEALTH CARE
RI
01
—
709358
ADA NATIONAL REGISTRATION
RI
Enumeration date
09/20/2006
Last updated
07/08/2007
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