Provider Demographics
NPI:1508480419
Name:WELLNESS WITH RACHITA
Entity Type:Organization
Organization Name:WELLNESS WITH RACHITA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED NUTRITIONIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHITA
Authorized Official - Middle Name:BHASIN
Authorized Official - Last Name:KENNY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CNS, CPT
Authorized Official - Phone:703-855-5506
Mailing Address - Street 1:4737 GRAND MASTERS WAY
Mailing Address - Street 2:
Mailing Address - City:LAKE RIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-5551
Mailing Address - Country:US
Mailing Address - Phone:703-855-5506
Mailing Address - Fax:
Practice Address - Street 1:4737 GRAND MASTERS WAY
Practice Address - Street 2:
Practice Address - City:LAKE RIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-5551
Practice Address - Country:US
Practice Address - Phone:703-855-5506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-05
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty