Provider Demographics
NPI:1417786641
Name:MICHELLE DIDNER NUTRITION LLC
Entity type:Organization
Organization Name:MICHELLE DIDNER NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NUTRITIONIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DIDNER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CNS, CDN
Authorized Official - Phone:203-800-1525
Mailing Address - Street 1:50 EDGEWATER COMMONS LN
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-6146
Mailing Address - Country:US
Mailing Address - Phone:203-800-1525
Mailing Address - Fax:
Practice Address - Street 1:50 EDGEWATER COMMONS LN
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-6146
Practice Address - Country:US
Practice Address - Phone:203-800-1525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-27
Last Update Date:2024-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist