Provider Demographics
NPI:1679102966
Name:WATER AND THE WELL
Entity type:Organization
Organization Name:WATER AND THE WELL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN, TRAINER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOIRON
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN, CPT-NASM
Authorized Official - Phone:256-631-5986
Mailing Address - Street 1:3950 FAIRSTED DR APT 264
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-4545
Mailing Address - Country:US
Mailing Address - Phone:256-631-5986
Mailing Address - Fax:
Practice Address - Street 1:3950 FAIRSTED DR APT 264
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-4545
Practice Address - Country:US
Practice Address - Phone:256-631-5986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty