Individual
DANIELLE J REVOYR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RDN, LD, CNSC
Contact information
Practice address
1 ELLIOT WAY, MANCHESTER, NH 03103-3502
(603) 663-2398
Mailing address
38 HAWTHORNE DR UNIT H111, BEDFORD, NH 03110-7025
(425) 591-4879
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2954
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1196
STATE OF NEW HAMPSHIRE BOARD OF LICENSED DIETITIANS
NH
01
—
2954
ALABAMA BOARD OF EXAMINERS FOR DIETETICS & NUTRITIONISTS
AL
01
—
86105708
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
01/19/2019
Last updated
08/24/2021
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