| Nourished Roots Consulting, Llc | |
|
406 Union St Saint Simons Island GA 31522-4230 | |
| (912) 515-5822 | |
| Not Available |
| Full Name | Nourished Roots Consulting, Llc |
|---|---|
| Speciality | Dietitian, Registered |
| Location | 406 Union St, Saint Simons Island, Georgia |
| Authorized Official Name and Position | Cassandra Defeo (OWNER) |
| Authorized Official Contact | 9125155822 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nourished Roots Consulting, Llc 406 Union St Saint Simons Island GA 31522-4230 Ph: () - | Nourished Roots Consulting, Llc 406 Union St Saint Simons Island GA 31522-4230 Ph: (912) 515-5822 |
| NPI Number | 1245100775 |
|---|---|
| Provider Enumeration Date | 11/10/2025 |
| Last Update Date | 11/10/2025 |
| Certification Date | 11/10/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245100775 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
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