Provider Demographics
NPI:1457507089
Name:THE NATURAL PATH TO WELLNESS, LLC
Entity Type:Organization
Organization Name:THE NATURAL PATH TO WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:P
Authorized Official - Last Name:TEVERBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DSC, ND, PHD
Authorized Official - Phone:317-569-1800
Mailing Address - Street 1:1040 E 86TH ST
Mailing Address - Street 2:SUITE 48-A
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1865
Mailing Address - Country:US
Mailing Address - Phone:317-569-1800
Mailing Address - Fax:317-663-0734
Practice Address - Street 1:1040 E 86TH ST
Practice Address - Street 2:SUITE 48-A
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1865
Practice Address - Country:US
Practice Address - Phone:317-569-1800
Practice Address - Fax:317-663-0734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-14
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty