Individual
AMY DANGELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
209 WESTLETON DR APT 14E, MYRTLE BEACH, SC 29572-2259
(978) 895-0913
Mailing address
209 WESTLETON DR APT 14E, MYRTLE BEACH, SC 29572-2259
(978) 895-0913
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
1391
NH
133V00000X
Registered Dietitian
Primary
2179
SC
133V00000X
Registered Dietitian
4942-NU-NU
MA
133V00000X
Registered Dietitian
74.0134235
VT
133V00000X
Registered Dietitian
L004920
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1391
STATE
NH
01
—
2179
STATE
SC
01
—
4942-NU-NU
STATE
MA
01
—
74.0134235
STATE
VT
01
—
L004920
STATE
NC
01
—
LD1424
STATE
NM
Enumeration date
08/28/2016
Last updated
06/02/2023
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