Individual
MARISSA YVETTE PRIETO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6601 MONTANA AVE, SUITE G OR H, EL PASO, TX 79925-2155
(915) 838-7604
(817) 789-6849
Mailing address
5316 TRAIL LAKE DR, FORT WORTH, TX 76133-1931
(817) 292-8787
(817) 789-6849
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
DT82097
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149984001
—
TX
05
—
207164901
—
TX
Enumeration date
10/24/2012
Last updated
10/24/2012
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