Provider Demographics
NPI:1053946863
Name:THOMAS-GILLESPIE, SHELIA ANGELA (LICENSE DIETICIAN)
Entity type:Individual
Prefix:
First Name:SHELIA
Middle Name:ANGELA
Last Name:THOMAS-GILLESPIE
Suffix:
Gender:F
Credentials:LICENSE DIETICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 I STREET NW
Mailing Address - Street 2:SUITE 900
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006
Mailing Address - Country:US
Mailing Address - Phone:202-296-8020
Mailing Address - Fax:202-296-8024
Practice Address - Street 1:1712 I STREET NW
Practice Address - Street 2:SUITE 900
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006
Practice Address - Country:US
Practice Address - Phone:202-296-8020
Practice Address - Fax:202-296-8024
Is Sole Proprietor?:No
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDI100000181133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered