Individual
MARISSA M STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-4238
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-4238
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI1006
ME
Other
Enumeration date
10/27/2009
Last updated
10/27/2009
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