Individual
MARISA PERUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN,LDN
Contact information
Practice address
118 SHAELI DR, SOMERSET, PA 15501-1805
(814) 443-0158
Mailing address
118 SHAELI DR, SOMERSET, PA 15501-1805
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN006331
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DN006331
—
PA
Enumeration date
10/05/2022
Last updated
10/05/2022
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