Provider Demographics
NPI:1881700110
Name:HERBERT, MELISSA LEA (RD)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:LEA
Last Name:HERBERT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:HERBERT
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1312 AMHERST AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-4021
Mailing Address - Country:US
Mailing Address - Phone:804-338-6966
Mailing Address - Fax:804-918-1017
Practice Address - Street 1:821 S. KING STREET SUITE I
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175
Practice Address - Country:US
Practice Address - Phone:703-722-1500
Practice Address - Fax:804-918-1017
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered