| Organization Name: | COUNSELING AND NUTRITION CENTER 360, LLC |
| NPI Number: | 1255767745 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ELIZABETH MARIE PEARL (OWNER) |
| Mailing Address: | 373 Highland Ave Suite 201 Somerville |
| State: | MA US |
| Postal Code: | 021442553 |
| Phone Number: | 7816741189 |
| Fax Number: | 7818632646 |
| NPI Enumeration Date: | 09/17/2013 |
| NPI Last Update Date: | 09/17/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | 1024 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |