Provider Demographics
NPI:1154045516
Name:NUTRITION COUNSELING CENTER LLC
Entity type:Organization
Organization Name:NUTRITION COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LEAD DIETITIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRIZIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JESUE
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:248-320-1469
Mailing Address - Street 1:3466 EVERETT DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-5072
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1750 S TELEGRAPH RD STE 102
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0177
Practice Address - Country:US
Practice Address - Phone:248-686-0340
Practice Address - Fax:248-655-7478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty