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Organization
TOTAL NUTRITION TECHNOLOGY, INC.
Active
Organization
TOTAL NUTRITION TECHNOLOGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VANESSA LARA PHD, CNS, LDN/LN (CSO)
(704) 549-9550
Entity
Organization
Contact information
Practice address
10400 MALLARD CREEK RD STE 340, CHARLOTTE, NC 28262-5203
(704) 549-9550
(704) 549-9570
Mailing address
10400 MALLARD CREEK RD STE 340, CHARLOTTE, NC 28262-5203
(704) 549-9550
(704) 549-9570
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
—
—
133V00000X
Registered Dietitian
Primary
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
—
—
133VN1006X
Metabolic Nutrition Registered Dietitian
—
—
136A00000X
Registered Dietetic Technician
—
—
Other
Enumeration date
01/31/2007
Last updated
08/27/2026
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