Healthcare Provider Details

I. General information

NPI: 1407653199
Provider Name (Legal Business Name): WITT'S END NUTRITION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2025
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11215 AVALANCHE WAY UNIT B
COLUMBIA MD
21044-3091
US

IV. Provider business mailing address

11215 AVALANCHE WAY UNIT B
COLUMBIA MD
21044-3091
US

V. Phone/Fax

Practice location:
  • Phone: 240-285-0224
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name: JESSICA WITT
Title or Position: OWNER
Credential: MS, CNS, LDN
Phone: 240-285-0224