Provider Demographics
NPI:1821422494
Name:WILLIAMS, CATHRYN (RD, LD, CSP)
Entity Type:Individual
Prefix:
First Name:CATHRYN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RD, LD, CSP
Other - Prefix:
Other - First Name:CATHRYN
Other - Middle Name:
Other - Last Name:BOES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:1517 TECHNOLOGY DR STE 101
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-5985
Mailing Address - Country:US
Mailing Address - Phone:757-339-3624
Mailing Address - Fax:
Practice Address - Street 1:1517 TECHNOLOGY DR STE 101
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-5985
Practice Address - Country:US
Practice Address - Phone:757-339-3624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-30
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT87061133V00000X
TXDT82878133V00000X
VA86008878133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered