Provider Demographics
NPI:1285121756
Name:TESSIER, EMILY MARIE (RDN)
Entity type:Individual
Prefix:MISS
First Name:EMILY
Middle Name:MARIE
Last Name:TESSIER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CARLTONS TRL
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02917-2225
Mailing Address - Country:US
Mailing Address - Phone:508-294-2583
Mailing Address - Fax:401-223-6897
Practice Address - Street 1:51 SOCKANOSSET CROSS RD RM 205
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-5536
Practice Address - Country:US
Practice Address - Phone:508-294-2583
Practice Address - Fax:401-223-6897
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILDN00936133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered