Provider Demographics
NPI:1407591464
Name:ANIC, GABRIELLA (PHD, MPH, MS)
Entity Type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:
Last Name:ANIC
Suffix:
Gender:F
Credentials:PHD, MPH, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1631 WHETSTONE WAY APT 613
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-5173
Mailing Address - Country:US
Mailing Address - Phone:941-518-8710
Mailing Address - Fax:
Practice Address - Street 1:1631 WHETSTONE WAY APT 613
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-5173
Practice Address - Country:US
Practice Address - Phone:941-518-8710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist