Provider Demographics
NPI:1447911250
Name:MINDFUL NOURISHMENT LLC
Entity type:Organization
Organization Name:MINDFUL NOURISHMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:RITINSKI
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, CSR, LDN
Authorized Official - Phone:570-875-7653
Mailing Address - Street 1:2510 GREEN PINE CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-3050
Mailing Address - Country:US
Mailing Address - Phone:570-875-7653
Mailing Address - Fax:
Practice Address - Street 1:2510 GREEN PINE CT
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-3050
Practice Address - Country:US
Practice Address - Phone:570-875-7653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, RenalGroup - Single Specialty