Provider Demographics
NPI:1871241273
Name:OSORIO, KATHERINE (CNS, LDN, MS)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:OSORIO
Suffix:
Gender:F
Credentials:CNS, LDN, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4730 BRADLEY BLVD APT 304
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-6333
Mailing Address - Country:US
Mailing Address - Phone:301-785-8175
Mailing Address - Fax:
Practice Address - Street 1:4730 BRADLEY BLVD APT 304
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6333
Practice Address - Country:US
Practice Address - Phone:301-785-8175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX5449133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDDX5449OtherLICENSED DIETITIAN NUTRITIONIST
18207OtherCERTIFIED NUTRITION SPECIALIST