Provider Demographics
NPI:1144043795
Name:GEM NUTRITION ASSESSMENT & COUNSELING LLC
Entity type:Organization
Organization Name:GEM NUTRITION ASSESSMENT & COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN/SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MARAS
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, RDN, LDN
Authorized Official - Phone:508-269-4463
Mailing Address - Street 1:80 LEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02324-2397
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:80 LEDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02324-2397
Practice Address - Country:US
Practice Address - Phone:508-269-4463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty