Provider Demographics
NPI:1316979719
Name:FLOYD, CASSANDRA ANGLISH (RD)
Entity type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:ANGLISH
Last Name:FLOYD
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15396 MARSH OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3771
Mailing Address - Country:US
Mailing Address - Phone:703-730-6350
Mailing Address - Fax:
Practice Address - Street 1:15396 MARSH OVERLOOK DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3771
Practice Address - Country:US
Practice Address - Phone:703-730-6350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL002850133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered