Provider Demographics
NPI:1760142566
Name:STEWART, MELISSA FAITH (RDN, LDN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:FAITH
Last Name:STEWART
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 SENECA AVE
Mailing Address - Street 2:
Mailing Address - City:ESSEX JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05452-3522
Mailing Address - Country:US
Mailing Address - Phone:802-871-0028
Mailing Address - Fax:
Practice Address - Street 1:142 W TWIN OAKS TER
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-7132
Practice Address - Country:US
Practice Address - Phone:802-658-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered