Provider Demographics
NPI:1962220855
Name:TINA LABARRE NUTRITION LLC
Entity type:Organization
Organization Name:TINA LABARRE NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:FAITH
Authorized Official - Last Name:LABARRE
Authorized Official - Suffix:
Authorized Official - Credentials:MS RD LDN
Authorized Official - Phone:802-324-2224
Mailing Address - Street 1:95 COUNTY FARM CROSS RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-6007
Mailing Address - Country:US
Mailing Address - Phone:802-324-2224
Mailing Address - Fax:
Practice Address - Street 1:2299 WOODBURY AVE STE 5
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:NH
Practice Address - Zip Code:03801-7854
Practice Address - Country:US
Practice Address - Phone:603-681-6388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-30
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty