Provider Demographics
NPI:1518603158
Name:KALOCINSKI, MEGAN FEDORENCHIK (NBC-HWC, CNS)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:FEDORENCHIK
Last Name:KALOCINSKI
Suffix:
Gender:F
Credentials:NBC-HWC, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 WINTHROPE DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-3938
Mailing Address - Country:US
Mailing Address - Phone:703-795-6277
Mailing Address - Fax:
Practice Address - Street 1:824 WINTHROPE DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-3938
Practice Address - Country:US
Practice Address - Phone:703-795-6277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X, 133NN1002X
VA444056330171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education