Individual
KYLIE FAGNANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RDN, LDN
Contact information
Practice address
22 DOW ST APT 1, PORTLAND, ME 04102-3325
(570) 220-3531
Mailing address
22 DOW ST APT 1, PORTLAND, ME 04102-3325
(570) 220-3531
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI1329
ME
Other
Enumeration date
10/05/2017
Last updated
10/05/2017
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