Individual
MARISA BROOKE FAIBISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, CSSD
Contact information
Practice address
9451 WESTPORT RD STE 122C, LOUISVILLE, KY 40241-2295
(502) 855-7325
(502) 855-7326
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
277028
KY
133VN1501X
Sports Dietetics Nutrition Registered Dietitian
L007094
NC
Other
Enumeration date
10/24/2022
Last updated
12/23/2025
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