Individual
MISS ALISSA M VILLARRUBIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
7601 SOUTHCREST PKWY, SOUTHAVEN, MS 38671-4739
(662) 772-3188
Mailing address
1313 ISLAND PL E, MEMPHIS, TN 38103-9022
(504) 251-5612
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D1233
MS
133V00000X
Registered Dietitian
LDN0000001847
TN
Other
Enumeration date
03/10/2008
Last updated
03/10/2008
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