Healthcare Provider Details

I. General information

NPI: 1942657713
Provider Name (Legal Business Name): NOW(NUTRITION, OBESITY, WEIGHT MANAGEMENT) PROGRAM FOR KIDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2016
Last Update Date: 05/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 BELLEVUE AVE 305
TRENTON NJ
08618-4513
US

IV. Provider business mailing address

416 BELLEVUE AVE 305
TRENTON NJ
08618-4513
US

V. Phone/Fax

Practice location:
  • Phone: 609-439-2129
  • Fax: 609-337-8002
Mailing address:
  • Phone: 609-439-2129
  • Fax: 609-337-8002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name: MS. FREENA R. JOHNSON
Title or Position: NUTRITIONIST, CERT.PERSONAL TRAINER
Credential: CPT
Phone: 609-439-2129