Provider Demographics
NPI:1497433213
Name:FOOD FOR MOOD FUNCTIONAL NUTRITION, LLC
Entity Type:Organization
Organization Name:FOOD FOR MOOD FUNCTIONAL NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALEMY
Authorized Official - Suffix:
Authorized Official - Credentials:CNS, LDN
Authorized Official - Phone:908-367-3160
Mailing Address - Street 1:34 CHARLES RD
Mailing Address - Street 2:
Mailing Address - City:STIRLING
Mailing Address - State:NJ
Mailing Address - Zip Code:07980-1032
Mailing Address - Country:US
Mailing Address - Phone:908-367-3160
Mailing Address - Fax:
Practice Address - Street 1:34 CHARLES RD
Practice Address - Street 2:
Practice Address - City:STIRLING
Practice Address - State:NJ
Practice Address - Zip Code:07980-1032
Practice Address - Country:US
Practice Address - Phone:908-367-3160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty