Provider Demographics
NPI:1497521157
Name:BLACK GIRLS NUTRITION
Entity Type:Organization
Organization Name:BLACK GIRLS NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:KATIA
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL-LAURENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:857-370-8321
Mailing Address - Street 1:399 BOYLSTON ST. 6TH FL
Mailing Address - Street 2:ATTN: BLACK GIRLS NUTRITION
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116
Mailing Address - Country:US
Mailing Address - Phone:857-370-8321
Mailing Address - Fax:
Practice Address - Street 1:399 BOYLSTON ST. 6TH FL
Practice Address - Street 2:ATTN: BLACK GIRLS NUTRITION
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116
Practice Address - Country:US
Practice Address - Phone:857-370-8321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty
No374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty