Individual
MIRANDA PAIGE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RDN, CDN
Contact information
Practice address
822 S PROSPECT ST, BURLINGTON, VT 05401-3513
(802) 222-6907
Mailing address
97 13TH AVE, HOLTSVILLE, NY 11742-2381
(631) 741-8852
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
011200
NY
Other
Enumeration date
01/29/2024
Last updated
06/19/2025
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