Provider Demographics
NPI:1598560476
Name:ROBICHAUD, ELYSE M
Entity type:Individual
Prefix:
First Name:ELYSE
Middle Name:M
Last Name:ROBICHAUD
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 1:4 LAWRENCE DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-2300
Mailing Address - Country:US
Mailing Address - Phone:774-573-9415
Mailing Address - Fax:
Practice Address - Street 1:4 LAWRENCE DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-2300
Practice Address - Country:US
Practice Address - Phone:774-573-9415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-15
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALDN7977133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered