Provider Demographics
NPI:1578181624
Name:CAPOZZI, KATHY EM (RDN)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:EM
Last Name:CAPOZZI
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 SALYOR WAY SW
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-5823
Mailing Address - Country:US
Mailing Address - Phone:703-777-8975
Mailing Address - Fax:
Practice Address - Street 1:400 SALYOR WAY SW
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-5823
Practice Address - Country:US
Practice Address - Phone:703-777-8975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered