Provider Demographics
NPI:1225713134
Name:NOURISHED NUTRITION COUNSELING & EDUCATION
Entity Type:Organization
Organization Name:NOURISHED NUTRITION COUNSELING & EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN NUTRITIONIST
Authorized Official - Prefix:
Authorized Official - First Name:CAITILIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MFN, RDN
Authorized Official - Phone:703-763-0718
Mailing Address - Street 1:10432 BALLS FORD RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-2517
Mailing Address - Country:US
Mailing Address - Phone:703-763-0718
Mailing Address - Fax:
Practice Address - Street 1:10432 BALLS FORD RD STE 300
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-2517
Practice Address - Country:US
Practice Address - Phone:703-763-0718
Practice Address - Fax:703-423-0295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty