Provider Demographics
NPI:1801654355
Name:SHAHANI, MARISSA RESHMA (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:RESHMA
Last Name:SHAHANI
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:MARISSA
Other - Middle Name:RESHMA
Other - Last Name:WOYTOWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7251 W LAKE MEAD BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-8380
Mailing Address - Country:US
Mailing Address - Phone:725-260-8605
Mailing Address - Fax:702-472-8604
Practice Address - Street 1:7251 W LAKE MEAD BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-8380
Practice Address - Country:US
Practice Address - Phone:725-260-8605
Practice Address - Fax:702-472-8604
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered