Healthcare Provider Details

I. General information

NPI: 1366951196
Provider Name (Legal Business Name): WELCOMING NUTRITION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2017
Last Update Date: 09/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5236 DAWES AVE
ALEXANDRIA VA
22311-1404
US

IV. Provider business mailing address

5627 3RD ST S
ARLINGTON VA
22204-1117
US

V. Phone/Fax

Practice location:
  • Phone: 571-446-0287
  • Fax:
Mailing address:
  • Phone: 732-567-6587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LUCY RUETIMAN
Title or Position: OWNER/NUTRITIONIST
Credential: MS, CNS
Phone: 571-446-0287