Individual
KATHERINE GRACE BONAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
163 FORT EVANS RD NE, LEESBURG, VA 20176-4420
(706) 443-2000
Mailing address
163 FORT EVANS RD NE, LEESBURG, VA 20176-4420
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171416160
DL
CO
Enumeration date
09/23/2022
Last updated
09/23/2022
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