Provider Demographics
NPI:1710222930
Name:NUTRITION TO GROW
Entity Type:Organization
Organization Name:NUTRITION TO GROW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:J
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:RD, CD
Authorized Official - Phone:812-249-6403
Mailing Address - Street 1:401 OHIO ST STE B1
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47807-3529
Mailing Address - Country:US
Mailing Address - Phone:812-917-4229
Mailing Address - Fax:812-917-4326
Practice Address - Street 1:401 OHIO ST STE B1
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47807-3529
Practice Address - Country:US
Practice Address - Phone:812-917-4229
Practice Address - Fax:812-917-4326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-28
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37001726A133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty