Provider Demographics
NPI:1750932505
Name:JOHNSON, JULIET (RD)
Entity type:Individual
Prefix:
First Name:JULIET
Middle Name:
Last Name:JOHNSON
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:UNIT 6050 BOX 160
Mailing Address - Street 2:
Mailing Address - City:DPO
Mailing Address - State:AE
Mailing Address - Zip Code:09892-0160
Mailing Address - Country:US
Mailing Address - Phone:703-349-2863
Mailing Address - Fax:
Practice Address - Street 1:AL MANSOURAH STREET BUILDING #2
Practice Address - Street 2:
Practice Address - City:AMMAN
Practice Address - State:AMMAN
Practice Address - Zip Code:11183
Practice Address - Country:JO
Practice Address - Phone:703-349-2863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-24
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered