Provider Demographics
NPI:1427828391
Name:NOURISH & FLOURISH NUTRITION THERAPY
Entity type:Organization
Organization Name:NOURISH & FLOURISH NUTRITION THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:BRIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-400-2988
Mailing Address - Street 1:20 SIMONSON LN
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-5249
Mailing Address - Country:US
Mailing Address - Phone:908-400-2988
Mailing Address - Fax:
Practice Address - Street 1:20 SIMONSON LN
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-5249
Practice Address - Country:US
Practice Address - Phone:908-400-2988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty