Provider Demographics
NPI:1437414901
Name:SOMA WELLNESS
Entity Type:Organization
Organization Name:SOMA WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:E
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:513-505-6800
Mailing Address - Street 1:9030 MONTGOMERY RD
Mailing Address - Street 2:C/O SOMA WELLNESS
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-7741
Mailing Address - Country:US
Mailing Address - Phone:513-505-6800
Mailing Address - Fax:513-297-9429
Practice Address - Street 1:9030 MONTGOMERY RD
Practice Address - Street 2:C/O SOMA WELLNESS
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-7741
Practice Address - Country:US
Practice Address - Phone:513-505-6800
Practice Address - Fax:513-297-9429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-10
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4082133V00000X, 133VN1005X
OH7357133VN1004X
OH4913133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, PediatricGroup - Single Specialty
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, RenalGroup - Single Specialty
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, MetabolicGroup - Single Specialty