Perfect Storm

NPI #1376226456 in Mc Lean, Virginia

Provider Information

NPI Number: 1376226456
Entity Type: Organization
Organization Name: Perfect Storm
Primary Specialty: Nutritionist
Enumeration Date: Aug 7, 2023
Last Updated: Aug 7, 2023

Practice Location

Address: 6800 FLEETWOOD RD STE 110
City: Mc Lean
State: Virginia
ZIP Code: 22101-3604
Phone: (703) 388-9073

Authorized Official

Name: MONDERRAY BLASSINGAME
Title: COO
Phone: (703) 388-9073

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nutritionist - Nutrition, Education — Nutrition, Education	133NN1002X
Health & Wellness Coach	171400000X
Nutritionist	133N00000X	Primary

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