Provider Demographics
NPI:1437736113
Name:THRIVE INSIDE NUTRITION LLC
Entity Type:Organization
Organization Name:THRIVE INSIDE NUTRITION LLC
Other - Org Name:BEYOND BEHAVIOR NUTRITION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CERTIFIED NUTRITION SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:S
Authorized Official - Last Name:CERDA
Authorized Official - Suffix:
Authorized Official - Credentials:CNS, LDN
Authorized Official - Phone:301-338-8859
Mailing Address - Street 1:12409 BUTLER DR NW
Mailing Address - Street 2:
Mailing Address - City:LAVALE
Mailing Address - State:MD
Mailing Address - Zip Code:21502-6027
Mailing Address - Country:US
Mailing Address - Phone:301-268-2302
Mailing Address - Fax:
Practice Address - Street 1:12409 BUTLER DR NW
Practice Address - Street 2:
Practice Address - City:LAVALE
Practice Address - State:MD
Practice Address - Zip Code:21502-6027
Practice Address - Country:US
Practice Address - Phone:301-268-2302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-27
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty