Provider Demographics
NPI:1427319284
Name:DREW, LIZA H (RD, LD)
Entity type:Individual
Prefix:MRS
First Name:LIZA
Middle Name:H
Last Name:DREW
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:MS
Other - First Name:LIZA
Other - Middle Name:H
Other - Last Name:UHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:127 TAYLOR POND RD
Mailing Address - Street 2:
Mailing Address - City:SULLIVAN
Mailing Address - State:NH
Mailing Address - Zip Code:03445-4420
Mailing Address - Country:US
Mailing Address - Phone:603-831-0688
Mailing Address - Fax:888-626-3687
Practice Address - Street 1:127 TAYLOR POND RD
Practice Address - Street 2:
Practice Address - City:SULLIVAN
Practice Address - State:NH
Practice Address - Zip Code:03445-4420
Practice Address - Country:US
Practice Address - Phone:603-831-0688
Practice Address - Fax:888-626-3687
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0632133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered