Provider Demographics
NPI:1548474356
Name:HARLIN, ELIZABETH T (RD CDE LDN)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:T
Last Name:HARLIN
Suffix:
Gender:F
Credentials:RD CDE LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 RESNIK RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360
Mailing Address - Country:US
Mailing Address - Phone:508-747-9775
Mailing Address - Fax:508-746-4208
Practice Address - Street 1:30 RESNIK RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360
Practice Address - Country:US
Practice Address - Phone:508-747-9775
Practice Address - Fax:508-746-4208
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1402133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
799247OtherTUFTS HP
39439LOtherHPHC
MALD0087OtherBCBA
39439LOtherHPHC