Provider Demographics
NPI:1992205918
Name:PENDLEBURY, AMANDA MARIE (MS, BCHN)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:MARIE
Last Name:PENDLEBURY
Suffix:
Gender:F
Credentials:MS, BCHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 PRESCOTT RD
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03263-3910
Mailing Address - Country:US
Mailing Address - Phone:603-290-2098
Mailing Address - Fax:
Practice Address - Street 1:80 PRESCOTT RD
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:NH
Practice Address - Zip Code:03263-3910
Practice Address - Country:US
Practice Address - Phone:603-290-2098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist