Provider Demographics
NPI:1982226510
Name:BRAINFOOD NUTRITION
Entity Type:Organization
Organization Name:BRAINFOOD NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CNS, LDN
Authorized Official - Phone:410-561-6241
Mailing Address - Street 1:5801 ROLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-1309
Mailing Address - Country:US
Mailing Address - Phone:410-561-6241
Mailing Address - Fax:
Practice Address - Street 1:5801 ROLAND AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-1309
Practice Address - Country:US
Practice Address - Phone:410-561-6241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-18
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty