Provider Demographics
NPI:1417423039
Name:YOUR FOREVER NUTRITION COUNSELING LLC
Entity Type:Organization
Organization Name:YOUR FOREVER NUTRITION COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:NOREEN
Authorized Official - Middle Name:BIRON
Authorized Official - Last Name:GALLO
Authorized Official - Suffix:
Authorized Official - Credentials:MSRD LD
Authorized Official - Phone:603-553-1334
Mailing Address - Street 1:9 KAREN RD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-1721
Mailing Address - Country:US
Mailing Address - Phone:603-553-1334
Mailing Address - Fax:
Practice Address - Street 1:9 KAREN RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-1721
Practice Address - Country:US
Practice Address - Phone:603-553-1334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-22
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty