Provider Demographics
NPI:1922580240
Name:JOURNEY TO A NEW YOU, LLC
Entity Type:Organization
Organization Name:JOURNEY TO A NEW YOU, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:HAYNES
Authorized Official - Last Name:ODELL
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:860-818-1835
Mailing Address - Street 1:12 NORFOLK RD
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06759-2537
Mailing Address - Country:US
Mailing Address - Phone:860-818-1835
Mailing Address - Fax:
Practice Address - Street 1:12 NORFOLK RD
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-2537
Practice Address - Country:US
Practice Address - Phone:860-818-1835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT86038079133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty