Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mind Body Soul Revival LLC

Organization Nutritionist · NPI 1487469961

Mind Body Soul Revival LLC is a Nutritionist in Lakewood, Colorado. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

845 Vance St
Lakewood, CO 80214-4828
Phone: (774) 270-7018
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nutritionist (primary) Taxonomy 133N00000X

Record details

NPI number1487469961
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Emma O'Connor — Registered Dietitian · (774) 270-7018
NPI enumeratedFebruary 11, 2025
Last updated in NPPESFebruary 11, 2025
Certification dateFebruary 11, 2025
Mailing address845 Vance St, Lakewood, CO 80214-4828

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