Provider Demographics
NPI:1043015977
Name:OLIVIA HENSAL NUTRITION LLC
Entity type:Organization
Organization Name:OLIVIA HENSAL NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLIVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENSAL
Authorized Official - Suffix:
Authorized Official - Credentials:CNS, CDN, LDN
Authorized Official - Phone:330-412-1473
Mailing Address - Street 1:129 NW 26TH ST APT 318
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33127-4522
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:129 NW 26TH ST APT 318
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-4522
Practice Address - Country:US
Practice Address - Phone:330-412-1473
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty