Provider Demographics
NPI:1396462404
Name:TREMBLAY, ASHLEY (RDN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:TREMBLAY
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 ROSEWALK LN
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-7201
Mailing Address - Country:US
Mailing Address - Phone:540-958-4014
Mailing Address - Fax:
Practice Address - Street 1:3959 ELECTRIC RD STE 465
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-4559
Practice Address - Country:US
Practice Address - Phone:540-958-4014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered