Healthcare Provider Details

I. General information

NPI: 1992627327
Provider Name (Legal Business Name): MARISA BARSOTTI RD,LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1577 PEMBERTON DR
COLUMBUS OH
43221-1443
US

IV. Provider business mailing address

1577 PEMBERTON DR
COLUMBUS OH
43221-1443
US

V. Phone/Fax

Practice location:
  • Phone: 614-623-6348
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD.5982
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: