Provider Demographics
NPI:1114477742
Name:LIVING HEALTHY NUTRITION CONSULTANTS
Entity Type:Organization
Organization Name:LIVING HEALTHY NUTRITION CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:DELORES
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LDN, CDE
Authorized Official - Phone:404-387-3884
Mailing Address - Street 1:790 MANAWAI ST
Mailing Address - Street 2:E-211
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-3299
Mailing Address - Country:US
Mailing Address - Phone:404-387-3884
Mailing Address - Fax:
Practice Address - Street 1:790 MANAWAI ST
Practice Address - Street 2:E-211
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-3299
Practice Address - Country:US
Practice Address - Phone:404-387-3884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI135-LD133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty