Provider Demographics
NPI:1639946650
Name:RIES, JESSICA (RDN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:RIES
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:OWEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2064 ROSLYN RD
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-1050
Mailing Address - Country:US
Mailing Address - Phone:989-854-3293
Mailing Address - Fax:
Practice Address - Street 1:2064 ROSLYN RD
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE WOODS
Practice Address - State:MI
Practice Address - Zip Code:48236-1050
Practice Address - Country:US
Practice Address - Phone:989-854-3293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered