Provider Demographics
NPI:1063680429
Name:SPINALE, VICTORIA (RD, LD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:SPINALE
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 SOUTH MAIN STREET
Mailing Address - Street 2:DEPT OF CLINICAL NUTRITION
Mailing Address - City:WOLFEBORO
Mailing Address - State:NH
Mailing Address - Zip Code:03894-0912
Mailing Address - Country:US
Mailing Address - Phone:603-569-7500
Mailing Address - Fax:603-569-7509
Practice Address - Street 1:240 S MAIN ST
Practice Address - Street 2:DEPT OF CLINICAL NUTRITION
Practice Address - City:WOLFEBORO
Practice Address - State:NH
Practice Address - Zip Code:03894-4411
Practice Address - Country:US
Practice Address - Phone:603-569-7500
Practice Address - Fax:603-569-7509
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH392133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered