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General NPI Number Information
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NPI Number | 1932056983
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Entity Type | Organization
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Legal Business Name | LIFE IN BALANCE NUTRITION LLC
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Dates
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Enumeration Date | 03/10/2026
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 407 FORTRESS WAY
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City | OCCOQUAN
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State | VA
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Zip | 22125-7700
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Country | US
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Telephone | 571-221-2156
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 88
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City | OCCOQUAN
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State | VA
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Zip | 22125-0088
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CERTIFIED NUTRITION SPECIALIST
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Name | RACHEL B JOHNSON
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Credential | CNS/LDN
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Telephone | 571-221-2156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1006X
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Taxonomy Name | Metabolic Nutrition Registered Dietitian
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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 | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #3
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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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