Lillie, Bonita
Lillie, Bonita is an individual health care provider with primary practice located at 2121 Eisenhower Ave Suite 200, Alexandria VA 22314-4698. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Lillie, Bonita can be contacted via phone (703) 519-0901.Contact Information
Primary practice address
2121 Eisenhower Ave Suite 200
Alexandria VA 22314-4698
Phone: (703) 519-0901
Fax: (703) 519-0902
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dietary & Nutritional Service Providers / Dietitian, Registered | 133V00000X | 2004009119 | Missouri |
Profile Details
NPI number | 1134305857 |
---|---|
LBN Legal business name | Lillie, Bonita |
Credentials | Registered Dietitian (RD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 11th, 2008 |
Last updated | Sep 18th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1134305857 | NPPES |
Other | G02785D01 | MEDICARE PTAN |
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