Healthcare Provider Details

I. General information

NPI: 1700793718
Provider Name (Legal Business Name): NATURAL TRINITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

849 FAIRMOUNT AVE STE 200-T47
TOWSON MD
21286-2624
US

IV. Provider business mailing address

849 FAIRMOUNT AVE STE 200-T47
TOWSON MD
21286-2624
US

V. Phone/Fax

Practice location:
  • Phone: 443-360-5161
  • Fax:
Mailing address:
  • Phone: 443-360-5161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name: DESIREE GOODE-GREEN
Title or Position: NUTRITIONIST - OWNER
Credential: LICENSES DIETITIAN
Phone: 443-360-5161