Healthcare Provider Details

I. General information

NPI: 1689141988
Provider Name (Legal Business Name): NO DIET DIETITIAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2018
Last Update Date: 03/02/2023
Certification Date: 03/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

822 S PROSPECT ST
BURLINGTON VT
05401-3513
US

IV. Provider business mailing address

163 BAYBERRY CIRCLE #204
BURLINGTON VT
05401
US

V. Phone/Fax

Practice location:
  • Phone: 802-222-6907
  • Fax:
Mailing address:
  • Phone: 646-771-7517
  • Fax: 802-497-2052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MS. VALERIE GOLDBERG
Title or Position: REGISTERED DIETITIAN, CEO
Credential: RD, CD
Phone: 646-771-7517