Provider Demographics
NPI:1679002547
Name:DIETITIAN IN YOUR KITCHEN
Entity Type:Organization
Organization Name:DIETITIAN IN YOUR KITCHEN
Other - Org Name:SWAP HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF NUTRITION SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:I
Authorized Official - Last Name:POLAND
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LD
Authorized Official - Phone:614-706-3495
Mailing Address - Street 1:212 TALLOWWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-4547
Mailing Address - Country:US
Mailing Address - Phone:614-706-3495
Mailing Address - Fax:855-771-8942
Practice Address - Street 1:1245 S SUNBURY RD STE 102
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-9444
Practice Address - Country:US
Practice Address - Phone:614-706-3495
Practice Address - Fax:855-771-8942
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOCIAL IMPACT TECHNOLOGIES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-05
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHO343440Medicaid