Organization
BODACIOUS NUTRITION LLC
Active
Other names
Bodacious Nutrition LLC, Joanna Pustilnik
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNA R PUSTILNIK MS RDN CDCES (OWNER)
(804) 787-4431
Entity
Organization
Contact information
Practice address
2134 S NELSON ST, ARLINGTON, VA 22204-5410
(804) 787-4431
Mailing address
2134 S NELSON ST, ARLINGTON, VA 22204-5410
(804) 787-4431
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053842518
—
VA
Enumeration date
12/11/2023
Last updated
12/11/2023
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