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General NPI Number Information
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NPI Number | 1477205433
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Entity Type | Organization
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Legal Business Name | ENLIGHTEN NUTRITION COUNSELING AND CARE, LLC
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Dates
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Enumeration Date | 01/21/2022
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Last Update Date | 04/12/2022
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Provider Practice Location Address
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Address Line | 2 CARDINAL PARK DR SE STE 104
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City | LEESBURG
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State | VA
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Zip | 20175-4437
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Country | US
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Telephone | 571-310-6029
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Fax |
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Provider Business Mailing Address
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Address Line | 11707 SUMMERCHASE CIR APT E
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City | RESTON
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State | VA
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Zip | 20194-1129
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Country | US
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Telephone | 571-291-0693
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | ALISON SERAMUR HALL
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Credential | MS RDN LDN
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Telephone | 571-291-0693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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