Healthcare Provider Details

I. General information

NPI: 1467919308
Provider Name (Legal Business Name): MARIA L. ALFARO RD, NBC-HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2019
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 EDGEHILL RD
LONDONDERRY VT
05148-9774
US

IV. Provider business mailing address

147 EDGEHILL RD
LONDONDERRY VT
05148-9774
US

V. Phone/Fax

Practice location:
  • Phone: 802-380-5722
  • Fax:
Mailing address:
  • Phone: 802-380-5722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-4032168
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: