Individual
MARISSA ALICE LUBICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86144689
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86144689
CDCR
—
Enumeration date
07/25/2022
Last updated
07/25/2022
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