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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134305857 NPPES
Other G02785D01 MEDICARE PTAN

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