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Organization
HEALTHFUL NUTRITION SERVICES PLLC
Active
Organization
HEALTHFUL NUTRITION SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE THEAGENE MS RD CSR CDN CDCES (OWNER)
(845) 270-5775
Entity
Organization
Contact information
Practice address
1 CRYSTAL HILL DR, POMONA, NY 10970-2601
(845) 520-8336
Mailing address
PO BOX 128, GARNERVILLE, NY 10923-0128
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
—
NULL
133NN1002X
Nutrition Education Nutritionist
—
—
133V00000X
Registered Dietitian
—
NULL
133V00000X
Registered Dietitian
—
—
133VN1005X
Renal Nutrition Registered Dietitian
Primary
—
NULL
133VN1005X
Renal Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
10/23/2023
Last updated
11/18/2023
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