Provider Demographics
NPI:1346124401
Name:THORSEN, MARISSA LAURENE (RDN)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:LAURENE
Last Name:THORSEN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 GENERAL MORGAN LN
Mailing Address - Street 2:
Mailing Address - City:GLEN GARDNER
Mailing Address - State:NJ
Mailing Address - Zip Code:08826-3161
Mailing Address - Country:US
Mailing Address - Phone:908-839-2492
Mailing Address - Fax:
Practice Address - Street 1:9 GENERAL MORGAN LN
Practice Address - Street 2:
Practice Address - City:GLEN GARDNER
Practice Address - State:NJ
Practice Address - Zip Code:08826-3161
Practice Address - Country:US
Practice Address - Phone:908-839-2492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-02
Last Update Date:2025-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered