Provider Demographics
NPI:1982140455
Name:KAREN COONEY HOLISTIC HEALTH LLC
Entity Type:Organization
Organization Name:KAREN COONEY HOLISTIC HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:COONEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CHC
Authorized Official - Phone:609-548-9029
Mailing Address - Street 1:105 PARKSIDE LN
Mailing Address - Street 2:
Mailing Address - City:WEST CREEK
Mailing Address - State:NJ
Mailing Address - Zip Code:08092-2832
Mailing Address - Country:US
Mailing Address - Phone:609-548-9029
Mailing Address - Fax:
Practice Address - Street 1:1064 S MAIN ST
Practice Address - Street 2:SUITE 1E, UNIT 204
Practice Address - City:WEST CREEK
Practice Address - State:NJ
Practice Address - Zip Code:08092-2912
Practice Address - Country:US
Practice Address - Phone:609-548-9029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1205277472OtherINDIVIDUAL NPI