Individual
MS. DIMEREZE MARY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
6 SAINT ANDREWS LN, BOOTHBAY HARBOR, ME 04538-1731
(207) 633-2121
(207) 633-1276
Mailing address
7 WILDERNESSS DR, BOOTHBAY, ME 04537-5022
(207) 633-3780
(207) 633-1276
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D14
ME
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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