Individual
JANE L MAHAN-WIEGAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., R.D.
Contact information
Practice address
1900 CAMPUS COMMONS DRIVE, SUITE 100, RESTON, VA 20191
(703) 606-5233
Mailing address
13527 OLD DAIRY ROAD, HERNDON, VA 20171
(703) 606-5233
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
12/02/2014
Last updated
02/28/2018
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