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Individual

MRS. LUCIA ISAC MITCHELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
700 FETTLER PARK, DUMFRIES HEALTH CENTER, DUMFRIES, VA 22025
(703) 441-7500
(202) 269-7484
Mailing address
3700 FETTLER PARK, DUMFRIES HEALTH CENTER, DUMFRIES, VA 22025
(703) 441-7500

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1040898
DC
133V00000X
Registered Dietitian
D1100000386
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1040898
REGISTER DIETITIAN (RD)
DC
01
D1100000386
DIETITIAN LICENSE
DC
Enumeration date
11/19/2010
Last updated
09/22/2015
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