Provider Demographics
NPI:1669618674
Name:NUTRITION CONSULTANT
Entity type:Organization
Organization Name:NUTRITION CONSULTANT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIONNE
Authorized Official - Middle Name:GAYE
Authorized Official - Last Name:FROST
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:202-365-1653
Mailing Address - Street 1:1355 SOMERSET PL NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1134
Mailing Address - Country:US
Mailing Address - Phone:202-722-4101
Mailing Address - Fax:
Practice Address - Street 1:1355 SOMERSET PLACE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011
Practice Address - Country:US
Practice Address - Phone:202-722-4101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-22
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCD1100000045261Q00000X, 261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center