Provider Demographics
NPI:1649502451
Name:MASSEY, ALISON H (MS, RD, CDCES)
Entity type:Individual
Prefix:MS
First Name:ALISON
Middle Name:H
Last Name:MASSEY
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Gender:F
Credentials:MS, RD, CDCES
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Mailing Address - Street 1:205 STEEPLE CHASE DRIVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-4054
Mailing Address - Country:US
Mailing Address - Phone:410-535-2005
Mailing Address - Fax:443-432-3683
Practice Address - Street 1:985 PRINCE FREDERICK BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-3492
Practice Address - Country:US
Practice Address - Phone:410-535-2005
Practice Address - Fax:410-535-4850
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2023-07-03
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Provider Licenses
StateLicense IDTaxonomies
MDDX3059133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDDX3059OtherLICENSE DIETITIAN NUTRITION