Provider Demographics
NPI:1417578287
Name:MONTROND CORREIA, CARLA A (ND, CNS)
Entity Type:Individual
Prefix:DR
First Name:CARLA
Middle Name:A
Last Name:MONTROND CORREIA
Suffix:
Gender:F
Credentials:ND, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 CONNECTICUT AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-2603
Mailing Address - Country:US
Mailing Address - Phone:202-630-1718
Mailing Address - Fax:
Practice Address - Street 1:1250 CONNECTICUT AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-2603
Practice Address - Country:US
Practice Address - Phone:202-630-1718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-02
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDCNS17639133N00000X
DCNP-0085175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCNP-0085OtherLICENSE NATUROPATH PHYSICIAN