Individual
TESS EMMA PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, RDN, IBCLC
Contact information
Practice address
3908 MEADOWS DR, INDIANAPOLIS, IN 46205-3114
(361) 774-4974
Mailing address
9031 HARRISON RUN CT, INDIANAPOLIS, IN 46256-1890
(361) 774-4974
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
86104229
IN
171400000X
Health & Wellness Coach
86104229
IN
174N00000X
Lactation Consultant (Non-RN)
Primary
L-319389
IN
Other
Enumeration date
08/02/2025
Last updated
08/02/2025
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