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Organization
EARTHSOUL NUTRITION THERAPY PLLC
Active
Organization
EARTHSOUL NUTRITION THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDRA FIERROS RD (CO-FOUNDER)
(603) 545-1553
Entity
Organization
Contact information
Practice address
15 BRAMHALL ST APT 4, PORTLAND, ME 04102-3122
(603) 793-3221
Mailing address
15 BRAMHALL ST APT 4, PORTLAND, ME 04102-3122
(603) 793-3221
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
NULL
133V00000X
Registered Dietitian
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
—
NULL
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
01/31/2024
Last updated
12/05/2024
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