Provider Demographics
NPI:1821793191
Name:SEALS, KELA (RDN, LDN)
Entity Type:Individual
Prefix:
First Name:KELA
Middle Name:
Last Name:SEALS
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 VIRGINIA MANOR RD STE 111
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-4213
Mailing Address - Country:US
Mailing Address - Phone:301-412-5408
Mailing Address - Fax:
Practice Address - Street 1:6900 VIRGINIA MANOR RD STE 111
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-4213
Practice Address - Country:US
Practice Address - Phone:301-412-5408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-04
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDI200001430133V00000X
MDDX5770133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered