Provider Demographics
NPI:1518488220
Name:YOURNUTRITION2GO, LLC
Entity Type:Organization
Organization Name:YOURNUTRITION2GO, LLC
Other - Org Name:YOURNUTRITION2GO, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DOUGHERTY
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:603-566-9180
Mailing Address - Street 1:2762 W MONTEREY PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-7336
Mailing Address - Country:US
Mailing Address - Phone:603-566-9180
Mailing Address - Fax:831-480-5743
Practice Address - Street 1:2762 W MONTEREY PL
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-7336
Practice Address - Country:US
Practice Address - Phone:603-566-9180
Practice Address - Fax:831-480-5743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-03
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty