Provider Demographics
NPI:1841683349
Name:MORIARTY, SHEILA BRAY (RD)
Entity type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:BRAY
Last Name:MORIARTY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:
Other - Last Name:BRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:10 GATEHOUSE ROAD #210
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002
Mailing Address - Country:US
Mailing Address - Phone:774-254-2996
Mailing Address - Fax:413-566-1031
Practice Address - Street 1:10 GATEHOUSE ROAD #210
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002
Practice Address - Country:US
Practice Address - Phone:774-254-2996
Practice Address - Fax:413-566-1031
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-09
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2860133V00000X
MA133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered