Provider Demographics
NPI:1396256228
Name:MAZZOCHI, LISA (RD, LD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:MAZZOCHI
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1462 PARKER MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:STRAFFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03884-6336
Mailing Address - Country:US
Mailing Address - Phone:603-973-0348
Mailing Address - Fax:
Practice Address - Street 1:8 COMMERCE WAY
Practice Address - Street 2:UNIT 3
Practice Address - City:BARRINGTON
Practice Address - State:NH
Practice Address - Zip Code:03825-3544
Practice Address - Country:US
Practice Address - Phone:603-973-0348
Practice Address - Fax:855-266-1161
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-18
Last Update Date:2018-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH57133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered