Provider Demographics
NPI:1992111082
Name:POHL, ALLISON AMANDA (RD)
Entity type:Individual
Prefix:MISS
First Name:ALLISON
Middle Name:AMANDA
Last Name:POHL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 N OAK ST
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-6805
Mailing Address - Country:US
Mailing Address - Phone:610-999-3758
Mailing Address - Fax:
Practice Address - Street 1:403 N OAK ST
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-6805
Practice Address - Country:US
Practice Address - Phone:610-999-3758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN005244133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered