Individual
JESSICA MARIE HAUSFELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
955 RIBAUT RD, BEAUFORT, SC 29902-5441
(843) 522-5083
Mailing address
955 RIBAUT RD, BEAUFORT, SC 29902-5441
(843) 522-5083
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1133
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1133
SC RD LICENSE
SC
Enumeration date
10/24/2018
Last updated
10/24/2018
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