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Organization
RELATE NUTRITION & THERAPY
Active
Organization
RELATE NUTRITION & THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE WAVRA MPH, RD, LD (OWNER)
(651) 216-6555
Entity
Organization
Contact information
Practice address
79 13TH AVE NE, SUITE 103B, MINNEAPOLIS, MN 55413
(651) 216-6555
Mailing address
79 13TH AVE NE, SUITE 103B, MINNEAPOLIS, MN 55413
(651) 216-6555
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
133V00000X
Registered Dietitian
—
NULL
133V00000X
Registered Dietitian
—
—
Other
Enumeration date
05/30/2019
Last updated
05/30/2019
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