Organization
PEDIATRIC NUTRITION SUPPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHEREE A HUGHES RD, LD (PEDIATRIC DIETITIAN)
(703) 727-6100
Entity
Organization
Contact information
Practice address
38731 RICKARD RD, LOVETTSVILLE, VA 20180-3115
(703) 727-6100
Mailing address
38731 RICKARD RD, LOVETTSVILLE, VA 20180-3115
(703) 727-6100
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
633
WV
252Y00000X
Early Intervention Provider Agency
676968
VA
Other
Enumeration date
02/14/2014
Last updated
02/14/2014
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