Medical Nutrition Therapy Consulting LLC

NPI #1588263404 in Grandview, Missouri

Provider Information

NPI Number: 1588263404
Entity Type: Organization
Organization Name: Medical Nutrition Therapy Consulting LLC
Primary Specialty: Clinic/Center
Enumeration Date: Oct 21, 2020
Last Updated: Dec 28, 2020

Practice Location

Address: 12404 BLUE RIDGE EXT
City: Grandview
State: Missouri
ZIP Code: 64030-1741
Phone: (816) 572-0471

Authorized Official

Name: WASHINGTON, AISHA L, RDN
Title: REGISTERED DIETITIAN NUTRITIONIST
Phone: (816) 572-0471

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Early Intervention Provider Agency	252Y00000X
Clinic/Center	261Q00000X	Primary

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