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General NPI Number Information
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NPI Number | 1538004403
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Entity Type | Organization
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Legal Business Name | HEALTHY HABITS NUTRITION & WELLNESS
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/20/2026
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Provider Practice Location Address
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Address Line | 130 PERRY RD
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City | BANGOR
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State | ME
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Zip | 04401-6722
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Country | US
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Telephone | 207-717-9224
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Fax |
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Provider Business Mailing Address
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Address Line | 23 HOPKINS RD
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City | HAMPDEN
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State | ME
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Zip | 04444-1218
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Country | US
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Telephone | 207-717-9224
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CRISTINA CLARK
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Credential | RDN, ATC
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Telephone | 207-717-9224
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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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