Provider Demographics
NPI:1669160339
Name:NOURISHED WITH LOVE LLC
Entity type:Organization
Organization Name:NOURISHED WITH LOVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER, REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, CDN, CEDS
Authorized Official - Phone:908-349-0075
Mailing Address - Street 1:39 AVENUE AT THE CMN
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4807
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:39 AVENUE AT THE CMN STE 106
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4560
Practice Address - Country:US
Practice Address - Phone:908-349-0075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty