Provider Demographics
NPI:1033751813
Name:SPIES, AMANDA LYNN (RDN, LD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:LYNN
Last Name:SPIES
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 TULLAHOMA DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-3214
Mailing Address - Country:US
Mailing Address - Phone:334-734-4134
Mailing Address - Fax:
Practice Address - Street 1:826 TULLAHOMA DR
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-3214
Practice Address - Country:US
Practice Address - Phone:334-734-4134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-13
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2832133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered