Basic Information
| Provider Information | |||||||||
| NPI: | 1689338048 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEISBLATT | ||||||||
| FirstName: | WENDY | ||||||||
| MiddleName: | LOUISE | ||||||||
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| Credential: | RDN, LDN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5703 LUXEMBURG ST APT 200 | ||||||||
| Address2: | |||||||||
| City: | NORTH BETHESDA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208523464 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2024155726 | ||||||||
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| Practice Location | |||||||||
| Address1: | 655 WATKINS MILL RD | ||||||||
| Address2: | |||||||||
| City: | GAITHERSBURG | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208793301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2406324000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/22/2021 | ||||||||
| LastUpdateDate: | 12/09/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | DX3277 | MD | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.