Provider Demographics
NPI:1992572275
Name:REVEIZ, ALLISON JOY (NTP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:JOY
Last Name:REVEIZ
Suffix:
Gender:F
Credentials:NTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 STONEMONT DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3550
Mailing Address - Country:US
Mailing Address - Phone:954-243-4155
Mailing Address - Fax:
Practice Address - Street 1:507 STONEMONT DR
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3550
Practice Address - Country:US
Practice Address - Phone:954-243-4155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty