Provider Demographics
NPI:1427324474
Name:PROFESSIONAL NUTRITION CONSULTING, LLC
Entity type:Organization
Organization Name:PROFESSIONAL NUTRITION CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:AGRESTI
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:814-881-8483
Mailing Address - Street 1:431 HILLTOP RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-2312
Mailing Address - Country:US
Mailing Address - Phone:814-881-8483
Mailing Address - Fax:
Practice Address - Street 1:431 HILLTOP RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-2312
Practice Address - Country:US
Practice Address - Phone:814-881-8483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA848023133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty