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General NPI Number Information
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NPI Number | 1508480419
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Entity Type | Organization
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Legal Business Name | WELLNESS WITH RACHITA
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Dates
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Enumeration Date | 06/05/2020
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 4737 GRAND MASTERS WAY
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City | LAKE RIDGE
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State | VA
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Zip | 22192-5551
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Country | US
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Telephone | 703-855-5506
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Fax |
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Provider Business Mailing Address
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Address Line | 4737 GRAND MASTERS WAY
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City | LAKE RIDGE
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State | VA
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Zip | 22192-5551
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Country | US
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Telephone | 703-855-5506
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Fax |
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Authorized Official
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Title or Position | CERTIFIED NUTRITIONIST
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Name | MRS. RACHITA BHASIN KENNY
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Credential | MS, CNS, CPT
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Telephone | 703-855-5506
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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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