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General NPI Number Information
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NPI Number | 1780071738
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Entity Type | Organization
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Legal Business Name | PARTNERING4WELLNESS
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Dates
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Enumeration Date | 04/16/2015
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Last Update Date | 04/17/2015
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Provider Practice Location Address
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Address Line | 9603 GREYFIELD CT
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City | BOWIE
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State | MD
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Zip | 20721-3180
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Country | US
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Telephone | 301-925-4209
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Fax |
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Provider Business Mailing Address
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Address Line | 9603 GREYFIELD CT
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City | BOWIE
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State | MD
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Zip | 20721-3180
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Country | US
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Telephone | 301-925-4209
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Fax |
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Authorized Official
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Title or Position | CERTIFIED LICENSED NUTRITIONIST
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Name | MRS. MICHON LYNETTE POWELL
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Credential | MS, CNS, LDN
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Telephone | 301-466-6493
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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 | DX3766
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License Number State | MD
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