Provider Demographics
NPI:1790815579
Name:WELLNESS RESOLUTIONS, LLC
Entity Type:Organization
Organization Name:WELLNESS RESOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN
Authorized Official - Phone:401-305-6602
Mailing Address - Street 1:1635 MINERAL SPRING AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904
Mailing Address - Country:US
Mailing Address - Phone:401-305-6602
Mailing Address - Fax:401-305-6617
Practice Address - Street 1:1635 MINERAL SPRING AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904
Practice Address - Country:US
Practice Address - Phone:401-305-6602
Practice Address - Fax:401-305-6617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILDN00528133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI709003391Medicare PIN