Provider Demographics
NPI:1578158184
Name:CRYSTAL SAVOY RD NUTRITION COUNSELING
Entity Type:Organization
Organization Name:CRYSTAL SAVOY RD NUTRITION COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVOY
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN
Authorized Official - Phone:617-435-0591
Mailing Address - Street 1:733 TURNPIKE ST # 122
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-6137
Mailing Address - Country:US
Mailing Address - Phone:617-435-0591
Mailing Address - Fax:888-655-0698
Practice Address - Street 1:733 TURNPIKE ST # 122
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-6137
Practice Address - Country:US
Practice Address - Phone:617-435-0591
Practice Address - Fax:888-655-0698
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CRYSTAL SAVOY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MACW2253430OtherBCBS