Provider Demographics
NPI:1730946898
Name:ROLES, JULIA ANNA (RD)
Entity type:Individual
Prefix:MS
First Name:JULIA
Middle Name:ANNA
Last Name:ROLES
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SIBLEY ST FL 3
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02907-3227
Mailing Address - Country:US
Mailing Address - Phone:203-215-5466
Mailing Address - Fax:
Practice Address - Street 1:8 SIBLEY ST FL 3
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02907-3227
Practice Address - Country:US
Practice Address - Phone:203-215-5466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI86242812133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered