Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
AMANDA ELLISTON, LDN, CLC
Active Sole ProprietorAMANDA ELLISTON, LDN, CLC is a Nutritionist healthcare provider located in WILBRAHAM, Massachusetts. NPI 1417674219 is currently active in the NPPES registry. Verify at CMS.
Nutritionist · WILBRAHAM, MA
Registration Details
- NPI Number
- 1417674219
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 21, 2022 (3.8391271033562 yrs)
- Last Updated
- Feb 3, 2026
- Licenses
-
20983 (MA)3157 (MA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
12 GLENN DRWILBRAHAM, MA, 010951404Browse MA providers · Browse ZIP 01095
- Phone
- 4136952884
- Primary Specialty
-
Nutritionist
133N00000X
- Additional Specialty
- Nutritionist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.