Provider Demographics
NPI:1376638841
Name:AMYOT, LOUISE G (RD, LD)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:G
Last Name:AMYOT
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:P.O. BOX 727
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01302
Mailing Address - Country:US
Mailing Address - Phone:413-773-5165
Mailing Address - Fax:413-772-0110
Practice Address - Street 1:74 MAIN STREET
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301
Practice Address - Country:US
Practice Address - Phone:413-774-7917
Practice Address - Fax:413-772-0110
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA248133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA39299OtherHARVARD PILGRIM
MA6300198OtherUNITED HEALTH CARE
MA000000032986OtherBOSTON HEALTH NET
MA29376OtherHEALTH NEW ENGLAND
MALD0038OtherBCBSMA
MA792486OtherTUFTS
MAMT0062Medicare UPIN