Provider Demographics
NPI:1669917803
Name:KAY, ANNIE (RDN, E-RYT500)
Entity type:Individual
Prefix:MS
First Name:ANNIE
Middle Name:
Last Name:KAY
Suffix:
Gender:F
Credentials:RDN, E-RYT500
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 N EGREMONT RD
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-1926
Mailing Address - Country:US
Mailing Address - Phone:413-524-2452
Mailing Address - Fax:
Practice Address - Street 1:130 N EGREMONT RD
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1926
Practice Address - Country:US
Practice Address - Phone:413-524-2452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-26
Last Update Date:2016-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1477133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered