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General NPI Number Information
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NPI Number | 1346917069
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Entity Type | Organization
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Legal Business Name | KRISTEN VOLLARO NUTRITION & WELLNESS LLC
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Dates
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Enumeration Date | 08/30/2021
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Last Update Date | 08/30/2021
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Provider Practice Location Address
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Address Line | 4 WILLOWBROOK RD
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City | CROMWELL
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State | CT
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Zip | 06416-2501
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Country | US
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Telephone | 860-227-3263
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Fax |
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Provider Business Mailing Address
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Address Line | 15 WESTWOOD RD
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City | IVORYTON
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State | CT
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Zip | 06442-1254
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Country | US
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Telephone | 860-227-3263
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTEN VOLLARO
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Credential | CDN, CNS
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Telephone | 860-227-3263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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