Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

A Balanced Life Wellness Clinic and Apothecary, LLC

Organization Nutritionist · NPI 1629478037

A Balanced Life Wellness Clinic and Apothecary, LLC is a Nutritionist in Reston, Virginia. Registered with an NPI since 2014.

In the registry since
2014
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1818 Library St Ste 500
Reston, VA 20190-6242
Phone: (301) 602-1518
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nutritionist (primary) Taxonomy 133N00000X

Record details

NPI number1629478037
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Betsy Costilo — President · (301) 602-1518
NPI enumeratedSeptember 4, 2014
Last updated in NPPESSeptember 4, 2014
Mailing address1818 Library St, Ste 500, Reston, VA 20190-6242

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