Healthcare Provider Details

I. General information

NPI: 1376638841
Provider Name (Legal Business Name): LOUISE G. AMYOT RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 MAIN STREET
GREENFIELD MA
01301
US

IV. Provider business mailing address

P.O. BOX 727
GREENFIELD MA
01302
US

V. Phone/Fax

Practice location:
  • Phone: 413-774-7917
  • Fax: 413-772-0110
Mailing address:
  • Phone: 413-773-5165
  • Fax: 413-772-0110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number248
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: