Individual
MITA SHAH BHAGAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13175 FOX HUNT LN, 163, HERNDON, VA 20171-5389
(908) 922-3743
Mailing address
13175 FOX HUNT LN, 163, HERNDON, VA 20171-5389
(908) 922-3743
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
Other
Enumeration date
11/20/2014
Last updated
11/20/2014
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