# HEALTHFUL NUTRITION SERVICES PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275315400
- **Authorized official:** MARIE THEAGENE MS RD CSR CDN CDCES (OWNER)
- **Authorized official phone:** (845) 270-5775

## Contact information

- **Practice address:** 1 CRYSTAL HILL DR, POMONA, NY 10970-2601
- **Practice address phone:** (845) 520-8336
- **Mailing address:** PO BOX 128, GARNERVILLE, NY 10923-0128

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133NN1002X | Nutrition Education Nutritionist | — | NULL | — |
| 133NN1002X | Nutrition Education Nutritionist | — | — | — |
| 133V00000X | Registered Dietitian | — | NULL | — |
| 133V00000X | Registered Dietitian | — | — | — |
| 133VN1005X | Renal Nutrition Registered Dietitian | — | NULL | Yes |
| 133VN1005X | Renal Nutrition Registered Dietitian | — | — | Yes |

## Other

- **Enumeration date:** 10/23/2023
- **Last updated:** 11/18/2023