Provider Demographics
NPI:1881965762
Name:THE ART OF LIVING HEALTHY,LLC
Entity type:Organization
Organization Name:THE ART OF LIVING HEALTHY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:KALONICK
Authorized Official - Suffix:
Authorized Official - Credentials:MS RD LD/N
Authorized Official - Phone:352-228-3050
Mailing Address - Street 1:419 S HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-6101
Mailing Address - Country:US
Mailing Address - Phone:352-602-7275
Mailing Address - Fax:
Practice Address - Street 1:419 S HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-6101
Practice Address - Country:US
Practice Address - Phone:352-602-7275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 4603133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty