Healthcare Provider Details

I. General information

NPI: 1366321820
Provider Name (Legal Business Name): MELISSA PASQUERILLA RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35075 SELL RD
LISBON OH
44432-9455
US

IV. Provider business mailing address

35075 SELL RD
LISBON OH
44432-9455
US

V. Phone/Fax

Practice location:
  • Phone: 330-942-7344
  • Fax:
Mailing address:
  • Phone: 330-942-7344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number08745
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: