Provider Demographics
NPI:1619176161
Name:KOHLHEPP, ELAINE MARIE (RD, CSR)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:MARIE
Last Name:KOHLHEPP
Suffix:
Gender:F
Credentials:RD, CSR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12418 WILLOW FALLS DR
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-2086
Mailing Address - Country:US
Mailing Address - Phone:703-421-5279
Mailing Address - Fax:
Practice Address - Street 1:12418 WILLOW FALLS DR
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-2086
Practice Address - Country:US
Practice Address - Phone:703-421-5279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-15
Last Update Date:2007-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal