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Individual

DR. MENTREL STANLEY YOUNG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DSC.,C.N.S.,C.D.-N.

Contact information

Practice address
79 HAWTHORNE ST, BRIDGEPORT, CT 06610-1606
(203) 400-1990
Mailing address
79 HAWTHORNE ST, BRIDGEPORT, CT 06610-1606
(203) 400-1990

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
000870
CT

Other

Enumeration date
11/24/2008
Last updated
01/31/2011
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