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General NPI Number Information
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NPI Number | 1255209540
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Entity Type | Organization
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Legal Business Name | BREAK THE CYCLE NUTRITION, LLC
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Dates
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Enumeration Date | 10/28/2025
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 1709 SONESTA CT
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City | RALEIGH
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State | NC
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Zip | 27613-8562
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Country | US
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Telephone | 919-622-2174
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Fax |
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Provider Business Mailing Address
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Address Line | 1709 SONESTA CT
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City | RALEIGH
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State | NC
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Zip | 27613-8562
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Country | US
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Telephone | 919-622-2174
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PATRICIA DIANE BUTLER
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Credential | RD, LDN, CDCES
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Telephone | 919-622-2174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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