MEDICARE: HUNGRY FOR HEALTH NUTRITION COUNSELING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1790430387
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUNGRY FOR HEALTH NUTRITION COUNSELING, LLC

Provider Business Mailing Address
First Line	:	1167 KINGSTOWN RD UNIT 3
Second Line	:
City	:	SOUTH KINGSTOWN
State	:	RI
Zip	:	02879-7902
Country	:	US
Telephone Number	:	401-363-2546
Fax Number	:	401-522-6062

Provider Business Practice Location Address
First Line	:	1167 KINGSTOWN RD UNIT 3
Second Line	:
City	:	SOUTH KINGSTOWN
State	:	RI
Zip	:	02879-7902
Country	:	US
Telephone Number	:	401-363-2546
Fax Number	:	401-522-6062

Authorized Official
Title or Position	:	OWNER, PROVIDER
Name	:	MRS. STEPHANIE S NICOL
Credential	:	MS, RDN, LDN
Telephone Number	:	401-363-2546

Provider Enumeration Date	:	02/13/2022
Last Update Date	:	02/13/2022

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