Provider Demographics
NPI:1285075333
Name:PELLETT, AMIRA Y (PHD, RD, LDN,)
Entity type:Individual
Prefix:DR
First Name:AMIRA
Middle Name:Y
Last Name:PELLETT
Suffix:
Gender:F
Credentials:PHD, RD, LDN,
Other - Prefix:MISS
Other - First Name:AMIRA
Other - Middle Name:Y
Other - Last Name:SROUJI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:26 SOUTH PROSPECT STREET SUITE NO. 9
Mailing Address - Street 2:VALLEY NUTRITION COUNSELLING
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002
Mailing Address - Country:US
Mailing Address - Phone:413-314-3438
Mailing Address - Fax:
Practice Address - Street 1:26 SOUTH PROSPECT STREET SUITE NO. 9
Practice Address - Street 2:VALLEY NUTRITION COUNSELLING,
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002
Practice Address - Country:US
Practice Address - Phone:413-314-3438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-17
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA740133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric