Provider Demographics
NPI:1689931073
Name:UPPER VALLEY NUTRITION SERVICES LLC
Entity Type:Organization
Organization Name:UPPER VALLEY NUTRITION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOSCHIAVO
Authorized Official - Suffix:
Authorized Official - Credentials:RD LD CD
Authorized Official - Phone:802-439-5120
Mailing Address - Street 1:191 CHASE HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05033-8121
Mailing Address - Country:US
Mailing Address - Phone:802-439-5120
Mailing Address - Fax:802-439-5120
Practice Address - Street 1:191 CHASE HOLLOW RD
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:VT
Practice Address - Zip Code:05033-8121
Practice Address - Country:US
Practice Address - Phone:802-439-5120
Practice Address - Fax:802-439-5120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0619133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty