Provider Demographics
NPI:1316135403
Name:FELIX - JOHNSON, KAVITHA (RD, CDE)
Entity type:Individual
Prefix:MRS
First Name:KAVITHA
Middle Name:
Last Name:FELIX - JOHNSON
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 MAPLE AVE W
Mailing Address - Street 2:SUITE 120
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4301
Mailing Address - Country:US
Mailing Address - Phone:703-938-8885
Mailing Address - Fax:703-242-2437
Practice Address - Street 1:301 MAPLE AVE W
Practice Address - Street 2:SUITE 120
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4301
Practice Address - Country:US
Practice Address - Phone:703-938-8885
Practice Address - Fax:703-242-2437
Is Sole Proprietor?:No
Enumeration Date:2007-10-15
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered