Provider Demographics
NPI:1568133981
Name:NUTRITION FOR HEALTH, LLC
Entity Type:Organization
Organization Name:NUTRITION FOR HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN, OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:AYANA
Authorized Official - Middle Name:K
Authorized Official - Last Name:DUDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RDN LDN
Authorized Official - Phone:267-997-4978
Mailing Address - Street 1:264 E JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-1643
Mailing Address - Country:US
Mailing Address - Phone:267-997-4978
Mailing Address - Fax:
Practice Address - Street 1:264 E JOHNSON ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-1643
Practice Address - Country:US
Practice Address - Phone:267-997-4978
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty