Provider Demographics
NPI:1265748123
Name:MCMAHON, FIONA MARIA (RD, LD, CPHQ)
Entity type:Individual
Prefix:
First Name:FIONA
Middle Name:MARIA
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:RD, LD, CPHQ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6212 N MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-5509
Mailing Address - Country:US
Mailing Address - Phone:703-658-4451
Mailing Address - Fax:703-658-4227
Practice Address - Street 1:6212 N MORGAN ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22312-5509
Practice Address - Country:US
Practice Address - Phone:703-658-4451
Practice Address - Fax:703-658-4227
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-29
Last Update Date:2010-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDI700133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered