Provider Demographics
NPI:1295497238
Name:PLANNED LIFESTYLE AND NUTRITION, LLC
Entity type:Organization
Organization Name:PLANNED LIFESTYLE AND NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURICE
Authorized Official - Middle Name:ANTOINETTE
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD
Authorized Official - Phone:860-890-1649
Mailing Address - Street 1:19 MAPLE EDGE DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-1615
Mailing Address - Country:US
Mailing Address - Phone:860-890-1649
Mailing Address - Fax:
Practice Address - Street 1:19 MAPLE EDGE DR
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-1615
Practice Address - Country:US
Practice Address - Phone:860-890-1649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-07
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty