Provider Demographics
NPI:1053190124
Name:ENGAGING NUTRITION
Entity type:Organization
Organization Name:ENGAGING NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:LIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYANOS DELOID
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LDN
Authorized Official - Phone:781-608-8397
Mailing Address - Street 1:28 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-3287
Mailing Address - Country:US
Mailing Address - Phone:781-608-8397
Mailing Address - Fax:
Practice Address - Street 1:28 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:MARBLEHEAD
Practice Address - State:MA
Practice Address - Zip Code:01945-3287
Practice Address - Country:US
Practice Address - Phone:781-608-8397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Multi-Specialty