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Individual

LAUREN JACKEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RDN

Contact information

Practice address
1031 STERLING RD STE 203, HERNDON, VA 20170-3873
(703) 466-5150
Mailing address
640 NATHAN PL NE, LEESBURG, VA 20176-2349

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
DX5814
MD
133V00000X
Registered Dietitian
Primary
VA

Other

Enumeration date
11/03/2022
Last updated
11/03/2022
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