Provider Demographics
NPI:1467919308
Name:ALFARO, MARIA L (RD, NBC-HWC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:L
Last Name:ALFARO
Suffix:
Gender:F
Credentials:RD, NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 EDGEHILL RD
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:VT
Mailing Address - Zip Code:05148-9774
Mailing Address - Country:US
Mailing Address - Phone:802-380-5722
Mailing Address - Fax:
Practice Address - Street 1:147 EDGEHILL RD
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:VT
Practice Address - Zip Code:05148-9774
Practice Address - Country:US
Practice Address - Phone:802-380-5722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-27
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
A-4032168171400000X
133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered