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General NPI Number Information
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NPI Number | 1700736576
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Entity Type | Organization
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Legal Business Name | OLIVE BRANCH NUTRITION, PLLC
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Dates
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Enumeration Date | 02/02/2026
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 100 MARINE AVE APT 6C
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City | BROOKLYN
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State | NY
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Zip | 11209-7219
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Country | US
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Telephone | 646-801-8789
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 90021
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City | BROOKLYN
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State | NY
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Zip | 11209-0021
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Country | US
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Telephone | 646-801-8789
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Fax |
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Authorized Official
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Title or Position | DIETITIAN, OWNER
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Name | LINDSAY WENGLER
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Credential | MS, RD, CDCES, CNSC
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Telephone | 646-801-8789
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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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