NPI 1265089361 · live from the CMS NPI Registry
Lacy Marie Amor, RD, IBCLC
Dietitian, Registered in Traverse City, MI. National Provider Identifier 1265089361, active.
NPI record
| NPI | 1265089361 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 766 Indian Trail Blvd, Traverse City, MI 49686 |
| Practice phone | 231-233-1774 |
| Enumerated | August 22, 2019 |
| Last updated | July 7, 2021 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered, Nutrition, Pediatric | 133VN1004X | — |
| Dietitian, Registered primary | 133V00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.