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NPI Code Detail

MEDICARE: DIETING DIFFERENTLY LLC

MEDICARE: DIETING DIFFERENTLY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1770361214
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIETING DIFFERENTLY LLC
Provider Business Mailing Address
First Line : 3495 TROUGH SPRINGS RD
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37043-3834
Country : US
Telephone Number : 240-708-6435
Fax Number :
Provider Business Practice Location Address
First Line : 10770 COLUMBIA PIKE STE 300
Second Line :
City : SILVER SPRING
State : MD
Zip : 20901-4439
Country : US
Telephone Number : 240-708-6435
Fax Number : 240-828-1574
Authorized Official
Title or Position : OWNER
Name : MRS. NATALIE JOY STEPHENS
Credential : RDN
Telephone Number : 240-708-6435
Provider Enumeration Date : 09/18/2023
Last Update Date : 01/05/2026

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Directions to “DIETING DIFFERENTLY LLC ” Practice Location

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