Individual
ERICA MULLALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3 LEWIS AVE, KITTERY, ME 03904-1441
(508) 440-9426
Mailing address
3 LEWIS AVE, KITTERY, ME 03904-1441
(508) 440-9426
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0510-2022
—
MA
05
—
0510-2022
—
ME
05
—
0510-2022
—
NH
Enumeration date
01/03/2022
Last updated
01/03/2022
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