Provider Demographics
NPI:1407190077
Name:NOURISHMENTOR
Entity Type:Organization
Organization Name:NOURISHMENTOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ REGISTERED DIETITIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LDN
Authorized Official - Phone:724-961-3817
Mailing Address - Street 1:4395 OLD WILLIAM PENN HWY
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668-1926
Mailing Address - Country:US
Mailing Address - Phone:724-961-3817
Mailing Address - Fax:724-733-7705
Practice Address - Street 1:4395 OLD WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-1926
Practice Address - Country:US
Practice Address - Phone:724-961-3817
Practice Address - Fax:724-733-7705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004460133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty