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General NPI Number Information
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NPI Number | 1801759352
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Entity Type | Organization
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Legal Business Name | SWEET SUPPORT & NUTRITION , LLC
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 100 WHEATFIELD DR STE 1
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City | MILFORD
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State | PA
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Zip | 18337-7699
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Country | US
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Telephone | 845-590-7926
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Fax |
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Provider Business Mailing Address
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Address Line | 1684 GREENVILLE TPKE
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City | PORT JERVIS
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State | NY
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Zip | 12771-3253
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Country | US
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Telephone | 845-590-7926
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Fax |
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Authorized Official
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Title or Position | LICENSED DIETITIAN NUTRITIONIST
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Name | LAURA SOUDANT
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Credential | CNS, LDN
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Telephone | 845-590-7926
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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