Provider Demographics
NPI:1548417959
Name:HABTEMARIAM, AYANA ALEXIS (RD, LDN)
Entity Type:Individual
Prefix:
First Name:AYANA
Middle Name:ALEXIS
Last Name:HABTEMARIAM
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:AYANA
Other - Middle Name:
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4001 9TH ST N STE 220
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-1900
Mailing Address - Country:US
Mailing Address - Phone:703-656-6631
Mailing Address - Fax:
Practice Address - Street 1:4001 9TH ST N STE 220
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1900
Practice Address - Country:US
Practice Address - Phone:703-656-6631
Practice Address - Fax:703-997-4108
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133NN1002X, 133V00000X
00985931133V00000X
PADN003836133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered