Individual
LARISSA DEPASQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
769 BROADWAY # 1019, NEW YORK, NY 10003-6803
(386) 315-4222
Mailing address
532 MOSAIC BLVD, DAYTONA BEACH, FL 32124-3777
(386) 315-4222
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND12218
FL
Other
Enumeration date
03/20/2024
Last updated
03/20/2024
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