Provider Demographics
NPI:1255209540
Name:BREAK THE CYCLE NUTRITION, LLC
Entity type:Organization
Organization Name:BREAK THE CYCLE NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN, CDCES
Authorized Official - Phone:919-622-2174
Mailing Address - Street 1:1709 SONESTA CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-8562
Mailing Address - Country:US
Mailing Address - Phone:919-622-2174
Mailing Address - Fax:
Practice Address - Street 1:1709 SONESTA CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-8562
Practice Address - Country:US
Practice Address - Phone:919-622-2174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-28
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty