Provider Demographics
NPI:1154845618
Name:COX, JUANITA LUCRICIA (ND, CNS,LDN)
Entity Type:Individual
Prefix:DR
First Name:JUANITA
Middle Name:LUCRICIA
Last Name:COX
Suffix:
Gender:F
Credentials:ND, CNS,LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6817 GEORGIA AVE NW APT 107
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-2525
Mailing Address - Country:US
Mailing Address - Phone:202-243-8357
Mailing Address - Fax:
Practice Address - Street 1:5415 W CEDAR LN
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1515
Practice Address - Country:US
Practice Address - Phone:301-530-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-26
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX4234133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty