Provider Demographics
NPI:1619144136
Name:STAHL, AMY LYNN (MS, RD, LD)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYNN
Last Name:STAHL
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8810 LOWELL ST
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-3220
Mailing Address - Country:US
Mailing Address - Phone:202-679-2188
Mailing Address - Fax:
Practice Address - Street 1:8810 LOWELL ST
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-3220
Practice Address - Country:US
Practice Address - Phone:202-679-2188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT 04626133V00000X
MDDX6271133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered