Provider Demographics
NPI:1124495957
Name:NOURISH FAMILY NUTRITION COACHING, LLC
Entity type:Organization
Organization Name:NOURISH FAMILY NUTRITION COACHING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:KATE
Authorized Official - Last Name:SUGIUCHI
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:410-370-0415
Mailing Address - Street 1:1 VIA SUMMA
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-8071
Mailing Address - Country:US
Mailing Address - Phone:410-370-0415
Mailing Address - Fax:
Practice Address - Street 1:1 VIA SUMMA
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-8071
Practice Address - Country:US
Practice Address - Phone:410-370-0415
Practice Address - Fax:443-873-0249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-27
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty