Provider Demographics
NPI:1730578246
Name:AFFILIATED NUTRITION CONSULTANTS, LLC
Entity type:Organization
Organization Name:AFFILIATED NUTRITION CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:KANDELL
Authorized Official - Last Name:KOTLER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN, CLE, CSP
Authorized Official - Phone:480-251-1303
Mailing Address - Street 1:8108 E MICHELLE DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-5404
Mailing Address - Country:US
Mailing Address - Phone:480-251-1303
Mailing Address - Fax:480-393-3072
Practice Address - Street 1:8108 E MICHELLE DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-5404
Practice Address - Country:US
Practice Address - Phone:480-251-1303
Practice Address - Fax:480-393-3072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-21
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, PediatricGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty