Healthcare Provider Details
I. General information
NPI: 1710327010
Provider Name (Legal Business Name): VALLEY NUTRITION COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/01/2013
Last Update Date: 07/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
26 S PROSPECT ST SUITE 9
AMHERST MA
01002-2362
US
IV. Provider business mailing address
26 S PROSPECT ST SUITE 9
AMHERST MA
01002-2362
US
V. Phone/Fax
- Phone: 413-314-3438
- Fax:
- Phone: 413-314-3438
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | 676 |
| License Number State | MA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133VN1004X |
| Taxonomy | Pediatric Nutrition Registered Dietitian |
| License Number | |
| License Number State | MA |
VIII. Authorized Official
Name: DR.
FATEMEH
GIAHI
Title or Position: REGISTERED DIETITIAN
Credential: PHD, RD
Phone: 413-314-3438