Provider Demographics
NPI:1124697040
Name:HASSINGER, MARILYN KAY (RD, LD, CNSC)
Entity type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:KAY
Last Name:HASSINGER
Suffix:
Gender:F
Credentials:RD, LD, CNSC
Other - Prefix:
Other - First Name:MARILYN
Other - Middle Name:GAMBLE
Other - Last Name:HASSINGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD, LD, CNSC
Mailing Address - Street 1:500 LONDON AVE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-1594
Mailing Address - Country:US
Mailing Address - Phone:937-578-2442
Mailing Address - Fax:
Practice Address - Street 1:500 LONDON AVE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-1594
Practice Address - Country:US
Practice Address - Phone:937-578-2442
Practice Address - Fax:937-578-2214
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHL2346133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered