Provider Demographics
NPI:1700453610
Name:JEN BELANGER NUTRITION LLC
Entity Type:Organization
Organization Name:JEN BELANGER NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BELANGER
Authorized Official - Suffix:
Authorized Official - Credentials:MS RD LDN
Authorized Official - Phone:413-658-8590
Mailing Address - Street 1:154 CHAUNCEY WALKER ST
Mailing Address - Street 2:
Mailing Address - City:BELCHERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01007-9695
Mailing Address - Country:US
Mailing Address - Phone:413-658-8590
Mailing Address - Fax:
Practice Address - Street 1:35 TURKEY HILL RD STE 201D
Practice Address - Street 2:
Practice Address - City:BELCHERTOWN
Practice Address - State:MA
Practice Address - Zip Code:01007-9032
Practice Address - Country:US
Practice Address - Phone:413-658-8590
Practice Address - Fax:413-341-8054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, PediatricGroup - Single Specialty