Provider Demographics
NPI:1972339794
Name:WATERHOUSE, EMILY KATHRYN (MS, RD, LDN)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:KATHRYN
Last Name:WATERHOUSE
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HAYNES RD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03037-1401
Mailing Address - Country:US
Mailing Address - Phone:603-463-7863
Mailing Address - Fax:
Practice Address - Street 1:23 WORKS WAY
Practice Address - Street 2:
Practice Address - City:SOMERSWORTH
Practice Address - State:NH
Practice Address - Zip Code:03878-1638
Practice Address - Country:US
Practice Address - Phone:603-742-2163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1558133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered