Organization
EMBARK NUTRITION COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN COSTELLO MS, RD, LDN (OWNER/DIETITIAN)
(413) 884-5230
Entity
Organization
Contact information
Practice address
824 ROOSEVELT TRL, WINDHAM, ME 04062-5370
(413) 884-5230
Mailing address
824 ROOSEVELT TRL # 294, WINDHAM, ME 04062-5370
(413) 884-5230
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
03/15/2024
Last updated
03/15/2024
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