Provider Demographics
NPI:1669015905
Name:FESSLER, THERESA A (MS RDN CNSC)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:A
Last Name:FESSLER
Suffix:
Gender:F
Credentials:MS RDN CNSC
Other - Prefix:MS
Other - First Name:THERESA
Other - Middle Name:A
Other - Last Name:FESSLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS RDN
Mailing Address - Street 1:PO BOX 800673
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22908-0673
Mailing Address - Country:US
Mailing Address - Phone:434-243-9797
Mailing Address - Fax:
Practice Address - Street 1:1215 LEE ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0816
Practice Address - Country:US
Practice Address - Phone:434-243-9797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered