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General NPI Number Information
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NPI Number | 1891660676
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Entity Type | Organization
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Legal Business Name | MYNDFL
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Dates
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Enumeration Date | 10/09/2025
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 2990 BETHESDA PL
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City | WINSTON SALEM
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State | NC
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Zip | 27103-3318
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Country | US
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Telephone | 708-232-6580
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Fax |
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Provider Business Mailing Address
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Address Line | 333 SKOKIE BLVD STE 101
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City | NORTHBROOK
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State | IL
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Zip | 60062-1621
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Country | US
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Telephone | 708-232-6580
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHARI KALIK-MILLER
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Credential |
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Telephone | 708-232-6580
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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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