Provider Demographics
NPI:1699118117
Name:BE HEALTHY NUTRITION CONSULTING LLC
Entity type:Organization
Organization Name:BE HEALTHY NUTRITION CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:ROTH
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:703-851-8932
Mailing Address - Street 1:21386 FERNBROOK CT
Mailing Address - Street 2:
Mailing Address - City:BROADLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:20148-4032
Mailing Address - Country:US
Mailing Address - Phone:703-851-8932
Mailing Address - Fax:
Practice Address - Street 1:21351 GENTRY DR
Practice Address - Street 2:SUITE 125
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-8510
Practice Address - Country:US
Practice Address - Phone:703-851-8932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-15
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty