# MEDICAL NUTRITION THERAPY CONSULTING LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MEDICAL NUTRITION THERAPY CONSULTING LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588263404
- **Authorized official:** WASHINGTON, AISHA L RDN (REGISTERED DIETITIAN NUTRITIONIST)
- **Authorized official phone:** (816) 572-0471

## Contact information

- **Practice address:** 12404 BLUE RIDGE EXT, GRANDVIEW, MO 64030-1741
- **Practice address phone:** (816) 572-0471
- **Practice address fax:** (816) 761-0478
- **Mailing address:** 12404 BLUE RIDGE EXT, GRANDVIEW, MO 64030-1741
- **Mailing address phone:** (816) 572-0471
- **Mailing address fax:** (816) 761-0478

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | — |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/21/2020
- **Last updated:** 12/28/2020