Organization
MINDFUL EATER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA ANNE MARSHALL RDN, LDN (DIETITIAN)
(724) 984-3911
Entity
Organization
Contact information
Practice address
2 MONASTERY ST, PITTSBURGH, PA 15203-1407
(724) 984-3911
Mailing address
2 MONASTERY ST, PITTSBURGH, PA 15203-1407
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
DN005561
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000727897
STATE OF PENNSYLVANIA DEPARTMENT OF REVENUE
PA
Enumeration date
12/09/2016
Last updated
12/09/2016
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