Provider Demographics
NPI:1255561494
Name:BARMMER, AYLA MARIEL (MS, RD, LDN)
Entity type:Individual
Prefix:MISS
First Name:AYLA
Middle Name:MARIEL
Last Name:BARMMER
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 LOWELL RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-1733
Mailing Address - Country:US
Mailing Address - Phone:617-631-8870
Mailing Address - Fax:888-835-5844
Practice Address - Street 1:97 LOWELL RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-1733
Practice Address - Country:US
Practice Address - Phone:617-631-8870
Practice Address - Fax:888-835-5844
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-22
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2715132700000X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No132700000XDietary & Nutritional Service ProvidersDietary Manager