Provider Demographics
NPI:1578000162
Name:STEPHANIE GRENERT CONSULTING, LLC
Entity Type:Organization
Organization Name:STEPHANIE GRENERT CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRENERT
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD
Authorized Official - Phone:205-547-0472
Mailing Address - Street 1:7160 CAHABA VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-6401
Mailing Address - Country:US
Mailing Address - Phone:205-547-0472
Mailing Address - Fax:205-332-3619
Practice Address - Street 1:7160 CAHABA VALLEY RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-6401
Practice Address - Country:US
Practice Address - Phone:205-547-0472
Practice Address - Fax:205-332-3619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-20
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2299133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty