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General NPI Number Information
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NPI Number | 1669618674
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Entity Type | Organization
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Legal Business Name | NUTRITION CONSULTANT
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Dates
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Enumeration Date | 12/22/2008
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Last Update Date | 12/22/2008
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Provider Practice Location Address
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Address Line | 1355 SOMERSET PLACE NW
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City | WASHINGTON
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State | DC
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Zip | 20011
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Country | US
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Telephone | 202-722-4101
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Fax |
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Provider Business Mailing Address
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Address Line | 1355 SOMERSET PL NW
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City | WASHINGTON
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State | DC
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Zip | 20011-1134
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Country | US
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Telephone | 202-722-4101
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Fax |
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Authorized Official
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Title or Position | REGISTERED DIETITIAN
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Name | MRS. DIONNE GAYE FROST
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Credential | RD
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Telephone | 202-365-1653
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | D1100000045
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 261QA0005X
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Taxonomy Name | Ambulatory Family Planning Facility
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License Number | D1100000045
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License Number State | DC
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