Provider Demographics
NPI:1710660485
Name:ROSSER, STEFANIE SANDRA (RD)
Entity Type:Individual
Prefix:MRS
First Name:STEFANIE
Middle Name:SANDRA
Last Name:ROSSER
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 1:10525 RUE CHAMBORD
Mailing Address - Street 2:
Mailing Address - City:MONTREAL
Mailing Address - State:QC
Mailing Address - Zip Code:H2C2R6
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:909 G STREET SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003
Practice Address - Country:US
Practice Address - Phone:202-738-4726
Practice Address - Fax:800-238-9511
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86372647133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered