Provider Demographics
NPI:1720663651
Name:DAL-RI, FABIANE (RDN, LDN)
Entity Type:Individual
Prefix:
First Name:FABIANE
Middle Name:
Last Name:DAL-RI
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3413 ANNANDALE RD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-3502
Mailing Address - Country:US
Mailing Address - Phone:703-850-3519
Mailing Address - Fax:
Practice Address - Street 1:3413 ANNANDALE RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3502
Practice Address - Country:US
Practice Address - Phone:703-850-3519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA86144214133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA86144214OtherACADEMY OF NUTRITION AND DIETETICS
MDDX5196OtherMARYLAND DEPARTMENT OF HEALTH - STATE BOARD OF DIETETIC PRACTICE