Provider Demographics
NPI:1396316956
Name:SOULFUL NUTRITION CONSULTING INC
Entity type:Organization
Organization Name:SOULFUL NUTRITION CONSULTING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARNER-SHARIF
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN
Authorized Official - Phone:708-977-0529
Mailing Address - Street 1:1301 W MADISON ST APT 307
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-1941
Mailing Address - Country:US
Mailing Address - Phone:708-228-0622
Mailing Address - Fax:
Practice Address - Street 1:1301 W MADISON ST APT 307
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-1941
Practice Address - Country:US
Practice Address - Phone:708-228-0622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty