Provider Demographics
NPI:1710502471
Name:RITCHIE, AMIE LEAH (RD, CSR)
Entity Type:Individual
Prefix:MRS
First Name:AMIE
Middle Name:LEAH
Last Name:RITCHIE
Suffix:
Gender:F
Credentials:RD, CSR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 LUELLA AVE
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-1836
Mailing Address - Country:US
Mailing Address - Phone:734-945-6015
Mailing Address - Fax:517-841-1712
Practice Address - Street 1:60 LUELLA AVE
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-1836
Practice Address - Country:US
Practice Address - Phone:734-945-6015
Practice Address - Fax:517-841-1712
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
01030757133V00000X, 133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
01030757OtherCDR