MEDICARE: WHOLE AND HEALTHY DIETARY COUNSELING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1225783939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHOLE AND HEALTHY DIETARY COUNSELING

Provider Business Mailing Address
First Line	:	641 N LAKE DR
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-2570
Country	:	US
Telephone Number	:	732-503-1274
Fax Number	:

Provider Business Practice Location Address
First Line	:	641 N LAKE DR
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-2570
Country	:	US
Telephone Number	:	732-503-1274
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ROCHEL WEBER
Credential	:	RDN
Telephone Number	:	732-503-1274

Provider Enumeration Date	:	02/21/2022
Last Update Date	:	02/21/2022

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