Provider Demographics
NPI: | 1407638208 |
---|---|
Name: | FIRST STEP NUTRITION CONSULTING, LLC |
Entity Type: | Organization |
Organization Name: | FIRST STEP NUTRITION CONSULTING, LLC |
Other - Org Name: | FIRST STEP NUTRITION CONSULTING, LLC |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | CO-OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | LAURA |
Authorized Official - Middle Name: | LYNN |
Authorized Official - Last Name: | CORWIN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | RDN,CLC |
Authorized Official - Phone: | 814-323-0715 |
Mailing Address - Street 1: | 3440 S HILL RD |
Mailing Address - Street 2: | |
Mailing Address - City: | MC KEAN |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 16426-2109 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 814-323-0715 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3440 S HILL RD |
Practice Address - Street 2: | |
Practice Address - City: | MC KEAN |
Practice Address - State: | PA |
Practice Address - Zip Code: | 16426-2109 |
Practice Address - Country: | US |
Practice Address - Phone: | 814-323-0715 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-10-17 |
Last Update Date: | 2023-11-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 133V00000X | Dietary & Nutritional Service Providers | Dietitian, Registered | Group - Multi-Specialty |