Provider Demographics
NPI:1023380094
Name:LOSCHIAVO, MELANIE ROSE (RD, LD, CD)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:ROSE
Last Name:LOSCHIAVO
Suffix:
Gender:F
Credentials:RD, LD, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 CHASE HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05033-8121
Mailing Address - Country:US
Mailing Address - Phone:802-439-5120
Mailing Address - Fax:
Practice Address - Street 1:191 CHASE HOLLOW RD
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:VT
Practice Address - Zip Code:05033-8121
Practice Address - Country:US
Practice Address - Phone:802-439-5120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0619133V00000X
VT074.0084027133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered