Healthcare Provider Details

I. General information

NPI: 1033918198
Provider Name (Legal Business Name): OLGA'S NUTRITION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2025
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 BRIAR HILL RD
WEST PAWLET VT
05775-9789
US

IV. Provider business mailing address

980 BRIAR HILL RD
WEST PAWLET VT
05775-9789
US

V. Phone/Fax

Practice location:
  • Phone: 617-549-6542
  • Fax:
Mailing address:
  • Phone: 617-549-6542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name: MRS. OLGA MICHELLE ARNOLD
Title or Position: FUNCTIONAL CLINICAL NUTRITIONIST
Credential: MS, CNS, LDN
Phone: 617-549-6542