Provider Demographics
NPI:1184305310
Name:MCCONNAHEY, ALIZA (MS, RDN, LDN)
Entity type:Individual
Prefix:
First Name:ALIZA
Middle Name:
Last Name:MCCONNAHEY
Suffix:
Gender:F
Credentials:MS, 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:PO BOX 25131
Mailing Address - Street 2:
Mailing Address - City:SILVERTHORNE
Mailing Address - State:CO
Mailing Address - Zip Code:80497-5131
Mailing Address - Country:US
Mailing Address - Phone:330-206-6994
Mailing Address - Fax:
Practice Address - Street 1:7124 RYAN GULCH RD APT 7124
Practice Address - Street 2:
Practice Address - City:SILVERTHORNE
Practice Address - State:CO
Practice Address - Zip Code:80498-5190
Practice Address - Country:US
Practice Address - Phone:330-206-6994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH09855133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered