Provider Demographics
NPI:1295978138
Name:TAKE CARE NUTRITION CONSULTING, LLC
Entity type:Organization
Organization Name:TAKE CARE NUTRITION CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:L
Authorized Official - Last Name:GILBERT-HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LD/N
Authorized Official - Phone:850-566-2121
Mailing Address - Street 1:2024 PT MILLIGAN RD
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:FL
Mailing Address - Zip Code:32352-5012
Mailing Address - Country:US
Mailing Address - Phone:850-566-2121
Mailing Address - Fax:
Practice Address - Street 1:1401 CLAUDE PICHARD DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5138
Practice Address - Country:US
Practice Address - Phone:850-566-2121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND2623133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty