Provider Demographics
NPI:1568296457
Name:HEART HAVEN NUTRITION CONSULTING LLC
Entity type:Organization
Organization Name:HEART HAVEN NUTRITION CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LEAD DIETITIAN
Authorized Official - Prefix:MISS
Authorized Official - First Name:MAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:RASHAD
Authorized Official - Suffix:
Authorized Official - Credentials:RD,LD
Authorized Official - Phone:214-831-1384
Mailing Address - Street 1:5900 BALCONES DR STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4298
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4025 WOODLAND PARK BLVD STE 102
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-8051
Practice Address - Country:US
Practice Address - Phone:901-552-6589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-02
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty