Provider Demographics
NPI:1972838563
Name:LEUCHTE, ALYSSA L (RD, LDN, CLC)
Entity Type:Individual
Prefix:MS
First Name:ALYSSA
Middle Name:L
Last Name:LEUCHTE
Suffix:
Gender:F
Credentials:RD, LDN, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 STILES RD
Mailing Address - Street 2:SUITE # 219
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2859
Mailing Address - Country:US
Mailing Address - Phone:603-893-8030
Mailing Address - Fax:603-890-3713
Practice Address - Street 1:23 STILES RD
Practice Address - Street 2:SUITE # 219
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2859
Practice Address - Country:US
Practice Address - Phone:603-893-8030
Practice Address - Fax:603-890-3713
Is Sole Proprietor?:No
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2792133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered