Provider Demographics
NPI:1366319790
Name:CLEMENTINA HEALTH LLC
Entity type:Organization
Organization Name:CLEMENTINA HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARAIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:THIAGO-MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:IBCLC
Authorized Official - Phone:610-554-9597
Mailing Address - Street 1:205 DEVELIN DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-1519
Mailing Address - Country:US
Mailing Address - Phone:610-554-9597
Mailing Address - Fax:
Practice Address - Street 1:205 DEVELIN DR
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-1519
Practice Address - Country:US
Practice Address - Phone:610-554-9597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-21
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)