Provider Demographics
NPI:1295404341
Name:STOWELL, TORI ELIZABETH (MS, RDN, LDN)
Entity Type:Individual
Prefix:
First Name:TORI
Middle Name:ELIZABETH
Last Name:STOWELL
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:ATHOL
Mailing Address - State:MA
Mailing Address - Zip Code:01331-3346
Mailing Address - Country:US
Mailing Address - Phone:978-895-9365
Mailing Address - Fax:
Practice Address - Street 1:500 SPRING ST
Practice Address - Street 2:
Practice Address - City:ATHOL
Practice Address - State:MA
Practice Address - Zip Code:01331-3346
Practice Address - Country:US
Practice Address - Phone:978-895-9365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-11
Last Update Date:2021-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4669133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered