Provider Demographics
NPI:1619569324
Name:ORSA, KATHLEEN (RD)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:
Last Name:ORSA
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 1:12828 GREAT OAK LN
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:VA
Mailing Address - Zip Code:20124-1521
Mailing Address - Country:US
Mailing Address - Phone:703-915-6989
Mailing Address - Fax:
Practice Address - Street 1:12828 GREAT OAK LN
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:VA
Practice Address - Zip Code:20124-1521
Practice Address - Country:US
Practice Address - Phone:703-915-6989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal