Individual
MS. LISE ANNE GLOEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
5275 LEE HWY, SUITE #101, ARLINGTON, VA 22207-1619
(703) 575-1007
(703) 358-8703
Mailing address
5275 LEE HWY, SUITE #101, ARLINGTON, VA 22207-1619
(703) 575-1007
(703) 358-8703
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1489551
CIGNA HEALTHCARE PROVIDER
VA
01
—
2294420
UNITED HEALTHCARE PROVIDE
VA
01
—
7480122
AETNA PROVIDER NUMBER
VA
Enumeration date
11/21/2006
Last updated
11/02/2010
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