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General NPI Number Information
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NPI Number | 1487193314
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Entity Type | Individual
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Provider Name | LILY ASSEFA MS, RDN, LDN
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Gender | Female
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Dates
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Enumeration Date | 02/12/2017
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Last Update Date | 02/12/2017
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Provider Practice Location Address
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Address Line | 11306 COLLEGE VIEW DR
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City | SILVER SPRING
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State | MD
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Zip | 20902-2529
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Country | US
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Telephone | 240-606-4988
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Fax |
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Provider Business Mailing Address
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Address Line | 13238 OSTERPORT DR
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City | SILVER SPRING
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State | MD
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Zip | 20906-5914
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Country | US
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Telephone | 240-606-4988
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | DX2490
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 815577
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License Number State | MD
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