Provider Demographics
NPI:1649605759
Name:MURRAY, ALLISON MARIE (RD)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:MARIE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3091 WESTOVER DR
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-3056
Mailing Address - Country:US
Mailing Address - Phone:814-880-8984
Mailing Address - Fax:
Practice Address - Street 1:3091 WESTOVER DR
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-3056
Practice Address - Country:US
Practice Address - Phone:814-880-8984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-08
Last Update Date:2013-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA963668133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered