Individual
MARISA RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
3724 JEFFERSON ST STE 104, AUSTIN, TX 78731-6204
(303) 720-4134
Mailing address
PO BOX 290, TABERNASH, CO 80478-0191
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
—
—
Other
Enumeration date
11/27/2024
Last updated
11/27/2024
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