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General NPI Number Information
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NPI Number | 1841747086
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Entity Type | Organization
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Legal Business Name | MY HAPPY WEIGHT
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Dates
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Enumeration Date | 09/06/2016
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Last Update Date | 09/06/2016
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Provider Practice Location Address
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Address Line | 14743 TAMARACK PL
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City | WOODBRIDGE
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State | VA
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Zip | 22191-3135
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Country | US
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Telephone | 240-601-4097
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Fax |
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Provider Business Mailing Address
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Address Line | 14743 TAMARACK PL
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City | WOODBRIDGE
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State | VA
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Zip | 22191-3135
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Country | US
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Telephone | 240-601-4097
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAN CHI THI NGUYEN
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Credential | MA, RD
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Telephone | 240-601-4097
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | DI100000639
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State | VA
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