Healthcare Provider Details

I. General information

NPI: 1356279764
Provider Name (Legal Business Name): THEA ET ASTRUM NUTRITION COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8763 W AUGUSTA AVE
GLENDALE AZ
85305-3921
US

IV. Provider business mailing address

8763 W AUGUSTA AVE
GLENDALE AZ
85305-3921
US

V. Phone/Fax

Practice location:
  • Phone: 623-570-6711
  • Fax:
Mailing address:
  • Phone: 623-570-6711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MARGARET J HENSLEY
Title or Position: OWNER
Credential: RD
Phone: 623-570-6711