Provider Demographics
NPI:1831827856
Name:MCCAIN, TESS AVERY (DT)
Entity type:Individual
Prefix:
First Name:TESS
Middle Name:AVERY
Last Name:MCCAIN
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
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Mailing Address - Street 1:981 HIGH HOUSE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-3510
Mailing Address - Country:US
Mailing Address - Phone:919-388-0111
Mailing Address - Fax:919-388-8668
Practice Address - Street 1:135 JACK BRANCH DRIVE
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28608-6567
Practice Address - Country:US
Practice Address - Phone:828-266-0030
Practice Address - Fax:828-398-4539
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-09
Last Update Date:2022-08-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NCL007015133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered