Individual
MARYANN M MACDONOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN, CDE
Contact information
Practice address
130 MARSHALL RD, LOWELL, MA 01852-5130
(978) 671-9118
Mailing address
17 MERIAM ST, WAKEFIELD, MA 01880-3633
(978) 671-9118
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
110
MA
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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