Healthcare Provider Details

I. General information

NPI: 1255223459
Provider Name (Legal Business Name): JESSICA STROSAHL PHD, RDN, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 CLIFTON RD NE STE 2200
ATLANTA GA
30322-1013
US

IV. Provider business mailing address

101 WOODRUFF CIRCLE 7TH FLOOR SUITE 7130
ATLANTA GA
30322-0001
US

V. Phone/Fax

Practice location:
  • Phone: 404-727-1528
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License NumberLD007077
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: