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General NPI Number Information
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NPI Number | 1487516563
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Entity Type | Organization
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Legal Business Name | COLLABORATIVE NUTRITION THERAPY LLC
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Dates
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Enumeration Date | 11/26/2025
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 2389 MAIN ST
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City | GLASTONBURY
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State | CT
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Zip | 06033-4617
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Country | US
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Telephone | 860-538-7277
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Fax | 186-034-5667
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Provider Business Mailing Address
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Address Line | 2389 MAIN ST
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City | GLASTONBURY
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State | CT
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Zip | 06033-4617
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Country | US
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Telephone | 860-292-0760
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Fax | 860-345-6678
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Authorized Official
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Title or Position | DIETITIAN/OWNER
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Name | MONIKA K RILEY
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Credential | RDN
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Telephone | 860-292-0760
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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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