Provider Demographics
NPI:1982872966
Name:HOLTZ, AMY E (RD)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:E
Last Name:HOLTZ
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 1:40 RICHIE RD
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-7827
Mailing Address - Country:US
Mailing Address - Phone:617-471-0540
Mailing Address - Fax:
Practice Address - Street 1:40 RICHIE RD
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-7827
Practice Address - Country:US
Practice Address - Phone:617-471-0540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MANU 2210133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered