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
—
—
133V00000X
Registered Dietitian
—
—
133VN1005X
Renal Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
10/23/2023
Last updated
11/18/2023
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