Provider Demographics
NPI:1215470968
Name:MORRA, KATIE (RD, LDN)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:MORRA
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 SANGAMORE RD
Mailing Address - Street 2:N270
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-2508
Mailing Address - Country:US
Mailing Address - Phone:240-507-5110
Mailing Address - Fax:844-682-8102
Practice Address - Street 1:4701 SANGAMORE RD
Practice Address - Street 2:N270
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-2508
Practice Address - Country:US
Practice Address - Phone:240-507-5110
Practice Address - Fax:844-682-8102
Is Sole Proprietor?:No
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX4079133N00000X
86009599133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist