Provider Demographics
NPI:1386151355
Name:RICHER, ALICE C
Entity type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:C
Last Name:RICHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:WRENTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02093-1828
Mailing Address - Country:US
Mailing Address - Phone:617-733-5565
Mailing Address - Fax:
Practice Address - Street 1:100 WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:WRENTHAM
Practice Address - State:MA
Practice Address - Zip Code:02093-1828
Practice Address - Country:US
Practice Address - Phone:617-733-5565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-29
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA600905133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered