Provider Demographics
NPI:1710046545
Name:ALLAIRE-PITTZ, JUDITH ELIZABETH (RD, CCRC)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ELIZABETH
Last Name:ALLAIRE-PITTZ
Suffix:
Gender:F
Credentials:RD, CCRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6254 KRAFT AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-2354
Mailing Address - Country:US
Mailing Address - Phone:702-401-2478
Mailing Address - Fax:702-233-2963
Practice Address - Street 1:1800 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2329
Practice Address - Country:US
Practice Address - Phone:702-383-3691
Practice Address - Fax:702-383-2954
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV544904132700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes132700000XDietary & Nutritional Service ProvidersDietary Manager