Organization
MCDONOUGH NUTRITIONAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LIBIA MCDONOUGH MS LC (NUTRITIONIST)
(202) 509-6991
Entity
Organization
Contact information
Practice address
6827 4TH ST NW, #104, WASHINGTON, DC 20012-1900
(202) 509-6991
Mailing address
6827 4TH ST NW, #104, WASHINGTON, DC 20012-1900
(202) 509-6991
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
NU89
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
083550100
—
DC
Enumeration date
09/14/2015
Last updated
09/14/2015
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