Provider Demographics
NPI:1891433298
Name:INNER PEACE NUTRITION COUNSELING
Entity Type:Organization
Organization Name:INNER PEACE NUTRITION COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:PATTEN
Authorized Official - Last Name:WILDER
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN, CEDRD
Authorized Official - Phone:508-344-6094
Mailing Address - Street 1:14 NASON ST STE 306
Mailing Address - Street 2:
Mailing Address - City:MAYNARD
Mailing Address - State:MA
Mailing Address - Zip Code:01754-2598
Mailing Address - Country:US
Mailing Address - Phone:508-344-6094
Mailing Address - Fax:
Practice Address - Street 1:14 NASON ST STE 306
Practice Address - Street 2:
Practice Address - City:MAYNARD
Practice Address - State:MA
Practice Address - Zip Code:01754-2598
Practice Address - Country:US
Practice Address - Phone:508-344-6094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty