Provider Demographics
NPI:1962137521
Name:RENZI, DEVYN (MS, CNS, LDN-PENDING)
Entity type:Individual
Prefix:
First Name:DEVYN
Middle Name:
Last Name:RENZI
Suffix:
Gender:F
Credentials:MS, CNS, LDN-PENDING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-1541
Mailing Address - Country:US
Mailing Address - Phone:413-281-4823
Mailing Address - Fax:
Practice Address - Street 1:510 NORTH ST STE 1
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4168
Practice Address - Country:US
Practice Address - Phone:413-447-2351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA133N00000X, 133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133N00000XDietary & Nutritional Service ProvidersNutritionist