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Individual

MARISSA GREGUREK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
4525 GUADALUPE ST APT 207, AUSTIN, TX 78751-3097
(979) 209-9104
Mailing address
4525 GUADALUPE ST APT 207, AUSTIN, TX 78751-3097

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT87342
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
86176279
REGISTERED DIETITIAN
01
DT87342
LICENSED DIETITIAN
TX
Enumeration date
06/28/2022
Last updated
06/28/2022
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