Individual
KELLY DORIS WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
41 DONALD B DEAN DR, SOUTH PORTLAND, ME 04106-3252
(207) 661-6064
Mailing address
41 DONALD B DEAN DR, SOUTH PORTLAND, ME 04106-3252
(072) 661-6064
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI149
ME
Other
Enumeration date
03/27/2020
Last updated
09/05/2024
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