Provider Demographics
NPI:1154029031
Name:AMELIA PAINTER NUTRITION COUNSELING LLC
Entity type:Organization
Organization Name:AMELIA PAINTER NUTRITION COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:AMELIA
Authorized Official - Last Name:PAINTER
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:801-691-2812
Mailing Address - Street 1:1250 W GLENOAKS BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-2281
Mailing Address - Country:US
Mailing Address - Phone:801-691-2812
Mailing Address - Fax:
Practice Address - Street 1:1250 W GLENOAKS BLVD STE E
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-2281
Practice Address - Country:US
Practice Address - Phone:801-691-2812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-20
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty