Provider Demographics
NPI:1215759964
Name:SOUL MIND AND STRENGTH LLC
Entity type:Organization
Organization Name:SOUL MIND AND STRENGTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:NIST-WEISEL
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:330-705-0643
Mailing Address - Street 1:11415 WRIGHT RD NW
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-5701
Mailing Address - Country:US
Mailing Address - Phone:330-705-0643
Mailing Address - Fax:330-266-7907
Practice Address - Street 1:800 W MAPLE ST STE B
Practice Address - Street 2:
Practice Address - City:HARTVILLE
Practice Address - State:OH
Practice Address - Zip Code:44632-9682
Practice Address - Country:US
Practice Address - Phone:330-705-0643
Practice Address - Fax:330-266-7907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Multi-Specialty