Provider Demographics
NPI:1184480824
Name:HALEY LEMIEUX NUTRITION LLC
Entity type:Organization
Organization Name:HALEY LEMIEUX NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HALEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMIEUX
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LDN, CDN
Authorized Official - Phone:802-379-1023
Mailing Address - Street 1:227 BOLTON ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02127-1301
Mailing Address - Country:US
Mailing Address - Phone:802-379-1023
Mailing Address - Fax:
Practice Address - Street 1:227 BOLTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127-1301
Practice Address - Country:US
Practice Address - Phone:802-379-1023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-21
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty