Provider Demographics
NPI:1033857925
Name:GABRIELLA ANIC NUTRITION, LLC
Entity Type:Organization
Organization Name:GABRIELLA ANIC NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NUTRITIONIST
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANIC
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MPH, MS
Authorized Official - Phone:941-518-8710
Mailing Address - Street 1:1631 WHETSTONE WAY APT 613
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-5173
Mailing Address - Country:US
Mailing Address - Phone:941-518-8710
Mailing Address - Fax:
Practice Address - Street 1:1631 WHETSTONE WAY APT 613
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-5173
Practice Address - Country:US
Practice Address - Phone:941-518-8710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-22
Last Update Date:2022-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty