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General NPI Number Information
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NPI Number | 1841189859
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Entity Type | Organization
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Legal Business Name | FUEL YOUR FREEDOM, PLLC
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 2592 N GREGG AVE STE 10
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-5520
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Country | US
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Telephone | 316-308-0030
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Fax |
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Provider Business Mailing Address
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Address Line | 2644 N GULLEY GROVE CIR
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-5496
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Country | US
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Telephone | 316-308-0030
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Fax |
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Authorized Official
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Title or Position | REGISTERED DIETITIAN
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Name | CAITLYN NEUENDORF
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Credential | RD
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Telephone | 316-308-0030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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