Provider Demographics
NPI:1164670899
Name:LOPEZ, ANNIE TERESA (RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:ANNIE
Middle Name:TERESA
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 IRVING ST NW
Mailing Address - Street 2:FOOD AND NUTRITION DEPARTMENT
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2921
Mailing Address - Country:US
Mailing Address - Phone:202-877-1043
Mailing Address - Fax:202-723-3816
Practice Address - Street 1:102 IRVING ST NW
Practice Address - Street 2:FOOD AND NUTRITION DEPARTMENT
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2921
Practice Address - Country:US
Practice Address - Phone:202-877-1043
Practice Address - Fax:202-723-3816
Is Sole Proprietor?:No
Enumeration Date:2008-09-06
Last Update Date:2008-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDI100000033133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered