Provider Demographics
NPI:1205394939
Name:TINA LABOY NUTRITION THERAPY LLC
Entity Type:Organization
Organization Name:TINA LABOY NUTRITION THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LABOY
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LD, CEDRDS
Authorized Official - Phone:512-522-7793
Mailing Address - Street 1:2520 LONGVIEW ST STE 211
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-4201
Mailing Address - Country:US
Mailing Address - Phone:512-522-7793
Mailing Address - Fax:818-484-2316
Practice Address - Street 1:2520 LONGVIEW ST STE 211
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-4201
Practice Address - Country:US
Practice Address - Phone:512-522-7793
Practice Address - Fax:818-484-2316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-12
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty