Healthcare Provider Details

I. General information

NPI: 1700644937
Provider Name (Legal Business Name): ALYSSA PAGLIA NUTRITION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2024
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3549 MARIPOSA ST
DENVER CO
80211-3044
US

IV. Provider business mailing address

3549 MARIPOSA ST
DENVER CO
80211-3044
US

V. Phone/Fax

Practice location:
  • Phone: 970-343-4368
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: ALYSSA PAGLIA
Title or Position: OWNER
Credential: RDN, LDN
Phone: 970-343-4368