Provider Demographics
NPI:1437970985
Name:SAAVEDRA, AMAIAH PRISCILLA (MS, RD, LD, CDM, CFP)
Entity type:Individual
Prefix:
First Name:AMAIAH
Middle Name:PRISCILLA
Last Name:SAAVEDRA
Suffix:
Gender:F
Credentials:MS, RD, LD, CDM, CFP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 JUNIPER
Mailing Address - Street 2:
Mailing Address - City:SOCORRO
Mailing Address - State:NM
Mailing Address - Zip Code:87801
Mailing Address - Country:US
Mailing Address - Phone:505-620-0159
Mailing Address - Fax:
Practice Address - Street 1:207 JUNIPER
Practice Address - Street 2:
Practice Address - City:SOCORRO
Practice Address - State:NM
Practice Address - Zip Code:87801
Practice Address - Country:US
Practice Address - Phone:505-620-0159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMLD2022013133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered