Provider Demographics
NPI:1538391636
Name:ELLIOTT CONSULTING, INC.
Entity type:Organization
Organization Name:ELLIOTT CONSULTING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:H
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD/N
Authorized Official - Phone:386-673-2915
Mailing Address - Street 1:18 LAKE VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-6785
Mailing Address - Country:US
Mailing Address - Phone:386-673-2915
Mailing Address - Fax:386-673-1714
Practice Address - Street 1:725 W GRANADA BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-9435
Practice Address - Country:US
Practice Address - Phone:386-673-2915
Practice Address - Fax:386-673-1714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-22
Last Update Date:2009-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 215133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty