NPI 1063086064 · live from the CMS NPI Registry
Maui Nutrition Therapy LLC
Dietitian, Registered in Kula, HI. National Provider Identifier 1063086064, active.
NPI record
| NPI | 1063086064 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 17732 Haleakala Hwy, Kula, HI 96790 |
| Practice phone | 808-269-9633 |
| Mailing address | Po Box 1147, Kula, HI 96790 |
| Enumerated | May 14, 2021 |
| Last updated | May 14, 2021 |
| Authorized official | Andrea De Roode, Owner |
| Other names | Maui Nutrition Therapy |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.