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General NPI Number Information
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NPI Number | 1336756493
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Entity Type | Organization
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Legal Business Name | BALANCED NUTRITION LLC
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Dates
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Enumeration Date | 09/23/2020
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Last Update Date | 06/08/2026
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Provider Practice Location Address
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Address Line | 4 RESEARCH PKWY STE 2
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City | WALLINGFORD
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State | CT
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Zip | 06492-1929
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Country | US
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Telephone | 860-351-3144
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Fax | 833-734-1474
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Provider Business Mailing Address
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Address Line | 95 SCENIC VIEW DR
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City | MIDDLETOWN
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State | CT
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Zip | 06457-4920
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Country | US
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Telephone | 860-214-7759
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Fax |
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Authorized Official
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Title or Position | OWNER/REGISTERED DIETITIAN
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Name | REBECCA BALEMIAN
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Credential | RD
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Telephone | 860-214-7759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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