Provider Demographics
NPI:1316458391
Name:LORINCZ, ALISHA MARIE (RD)
Entity type:Individual
Prefix:MS
First Name:ALISHA
Middle Name:MARIE
Last Name:LORINCZ
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18856 SAVAGE RD
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48111-9674
Mailing Address - Country:US
Mailing Address - Phone:734-624-0143
Mailing Address - Fax:
Practice Address - Street 1:533 MAIN ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48111-2649
Practice Address - Country:US
Practice Address - Phone:734-716-5588
Practice Address - Fax:267-859-0469
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-18
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered